Spect scintigraphic TC-99m HMPAO appearance in pre- and post electroconvusive therapy (ECT) in patients with major depression
Date
2014-04-07
Authors
Vangu, Mboyo-Di-Tamba Heb'En Willy
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Abstract
The attention recently gained by functional brain imaging research in affective
disorders is considerable. Decreases in regional cerebral blood flow in depressed patients
have been reported in the limbic and paralimbic areas by tomographic imaging techniques
(Ito et al, 1996; Mayberg et al, 1994). Studies examining the long term effects of
electroconvulsive therapy (ECT) on the cerebral perfusion demonstrate contrasting results
in both the responders and non responders (Silfverskiold et al, 1986; Nobler et al, 1994).
The aim ofthis study was to observe regional cerebral blood flow (rCBF) changes
in patients with major depression while using brain SPECT imaging before and after a
course of ECT.
15 patients with major depression diagnosed according to DSM-IV criteria were
investigated in this study., They were 11 females and 4 males who did not respond to
pharmaceutical treatment. Their mean age was 36.9 + 11.9 and except for two who refused
ECT after the pretreatment imaging, all the others scored at least 17 on the Hamilton
Rating Scale for Depression (HAM-D), mean 25.8 ± 4.7.
The data analysis consisted of visual assessment and semiquantitetive evaluation
of 99mTc-HMPAO uptake ratios measured between cerebral regions of interest and the
cerebellum.
The results in the group of responders showed obvious improvement on visual assessment
and unchanged patterns in non responders. Two of the 15 patients showed signs of post
traumatic stress disorder (PTSD) after ECT and demonstrated peculiar patterns regarding
their response to therapy. When patients were considered as a whole, significant changes
on the semiquantitative evaluation were noted in the anterior cingulate gyrus and the left
frontal area, in keeping with available literature. When patients were separated in groups
of responders versus non responders however, no significant change was noted between
the pre and post ECT studies.