Research On Cerebral Blood Flow In Patients With Depressive Disorder Using SPECT And Acetazolamide SPECT Stress Test

Objective:To observe regional cerebral blood flow (rCBF) changes using SPECT, cerebral vasoreactivity and possible potential cerebral hypoperfusion using acetazolamide SPECT stress test in patients with depressive disorder; as well as to determine the correlation of cerebral hypoperfusion with the severity of depression. Method:Eighteen unmedicated patients fulfilling the CCMD-3 criteria for depressive disorder and nineteen healthy control subjects were included. Baseline SPECT was performed in both patients and control subjects, and acetazolamide SPECT stress test was performed 2 days later in patients after orally administration of 2 g acetazolamide. Hamilton Depression (HAMD) score and Hamilton Anxiety (HAMA) score was determined to represent the severity of depression. Result:Compared with the control subjects, obvious decrease of rCBF in both sides of frontal and temporal lobes, as well as in left parietal lobe and right basal ganglia with smaller extent, was found (P<0.05~0.01). Meanwhile, the cerebral hypoperfusion in both sides was asymmetric-lower in the left. After administration of acetazolamide, the decreased rCBF of all regions in patients was significantly improved, recovered to normal levels, and no potential cerebral ischemic region was found. Furthermore, the rCBF was correlated with certain subtype factors, but not the total score, of the HAMD score, while the decrease of rCBF in both frontal lobes was correlated with total score of HAMA. Conclusion:Cerebral hypoperfusion exists in patients with depressive disorder; acetazolamide SPECT stress test failed to evoke potential cerebral hypoperfusion, and by contrast, made the decreased rCBF recover to normal level. That suggests the cerebral vasoreactivity is intact in patients with depressive disorder, the decrease of rCBF is not due to the organic reasons of vessels.