Assessing Regional Cerebral Blood Flow in Depression Using 320-Slice Computed Tomography

Abstract

While there is evidence that the development and course of major depressive disorder (MDD) symptomatology is associated with vascular disease, and that there are changes in energy utilization in the disorder, the extent to which cerebral blood flow is changed in this condition is not clear. This study utilized a novel imaging technique previously used in coronary and stroke patients, 320-slice Computed-Tomography (CT), to assess regional cerebral blood flow (rCBF) in those with MDD and examine the pattern of regional cerebral perfusion. Thirty nine participants with depressive symptoms (Hamilton Depression Rating Scale 24 (HAMD24) score >20, and Self-Rating Depression Scale (SDS) score >53) and 41 healthy volunteers were studied. For all subjects, 3 ml of venous blood was collected to assess hematological parameters. Trancranial Doppler (TCD) ultrasound was utilized to measure parameters of cerebral artery rCBFV and analyse the Pulsatility Index (PI). 16 subjects (8 = MDD; 8 = healthy) also had rCBF measured in different cerebral artery regions using 320-slice CT. Differences among groups were analyzed using ANOVA and Pearson's tests were employed in our statistical analyses. Compared with the control group, whole blood viscosity (including high\middle\low shear rate)and hematocrit (HCT) were significantly increased in the MDD group. PI values in different cerebral artery regions and parameters of rCBFV in the cerebral arteries were decreased in depressive participants, and there was a positive relationship between rCBFV and the corresponding vascular rCBF in both gray and white matter. rCBF of the left gray matter was lower than that of the right in MDD. Major depression is characterized by a wide range of CBF impairments and prominent changes in gray matter blood flow. 320-slice CT appears to be a valid and promising tool for measuring rCBF, and could thus be employed in psychiatric settings for biomarker and treatment response purposes.

Pseudo-continuous arterial spin labeling imaging of cerebral blood perfusion asymmetry in drug-naïve patients with first-episode major depression

“…For example, a study using 320-Slice Computed Tomography found that the rCBF of the left hemisphere is lower than that in the right hemisphere in depression patients (14), although the present study did not find that rCBF increased in the right hemisphere in depression patients compared with the healthy control subjects. Additionally, numerous electrophysiology studies confirmed that brain electrical activity also exhibits an asymmetric pattern.…”

Aberrant patterns of brain cerebral blood flow in Chinese han first-episode drug-naïve depressive patients with and without a family history of depression

“…The specific alteration in the patients with a family history was the increased rCBF in the bilateral basal ganglia, the bilateral middle temporal gyrus, the lateral inferior gyrus, the left paracentral gyrus, the right thalamus, these findings supported the hypothesis that increased cerebellar-default-mode-network connectivity in MDD patients to some extent [ 27 ]. Previous studies confirmed that functional or structural alterations in the prefrontal-limbic system participated in the regulation of affection, the regulation of memory processes and executive function [ 7 , 28 – 31 ]. Previous studies have also reported that decreased rCBF was also found in the prefrontal cortex and the orbital prefrontal cortex and that these brain regions participated in the regulation of aggression, sexual functioning and perseverative affection processing [ 23 , 31 – 33 ].…”

“…Previous studies confirmed that functional or structural alterations in the prefrontal-limbic system participated in the regulation of affection, the regulation of memory processes and executive function [ 7 , 28 – 31 ]. Previous studies have also reported that decreased rCBF was also found in the prefrontal cortex and the orbital prefrontal cortex and that these brain regions participated in the regulation of aggression, sexual functioning and perseverative affection processing [ 23 , 31 – 33 ]. In addition, decreased rCBF in the insular in our present study supported the hypothesis that insular act as an integration center of emotional processing which is disrupted in the depressed patients [ 34 ].…”

Comorbid depressive disorders and left‐side dominant occlusal discomfort in patients with phantom bite syndrome

“…A lot of brain imaging studies for patients with depression have reported blood flow changes in various portions of the brain . However, these results were not necessarily consistent, partly due to the heterogeneity in depression.…”

“…A lot of brain imaging studies for patients with depression have reported blood flow changes in various portions of the brain. 17,18 However, these results were not necessarily consistent, partly due to the heterogeneity in depression. Among them, asymmetry in grey matter volume reduction or cerebral blood flow between bilateral hemispheres has been reported.…”