HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Joe, A. Y. Articles by Zobel, A. Search for Related Content PubMed PubMed Citation Articles by Joe, A. Y. Articles by Zobel, A.

Response-Dependent Differences in Regional Cerebral Blood Flow Changes with Citalopram in Treatment of Major Depression

¹ Department of Nuclear Medicine; University of Bonn, Bonn, Germany; and ² Department of Psychiatry; University of Bonn, Bonn, Germany

Correspondence: For correspondence or reprints contact: Astrid Zobel, MD, Department of Psychiatry, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany. E-mail: astrid.zobel{at}ukb.uni-bonn.de

Major depression (MD) is the most frequent psychiatric disorder with a predicted increase within the next decade. The understanding of the neurobiologic basis of its cause, antidepressive treatment effects, and identification of treatment outcome predictors is of crucial importance to warrant efficient medical care. The aim of our study was to investigate differences of regional cerebral blood flow (rCBF) in MD between responders and nonresponders in the beginning and differences during the course of treatment. Methods: ^99mTc-Labeled D,L-hexamethylpropyleneamine oxime brain scans under resting conditions were performed on 65 patients with MD. All patients were treated with citalopram as an antidepressive monotherapy. SPECT scans were performed 2 times, at the beginning (t1) and after 4 wk of medication (t2). Voxel-by-voxel analyses were performed using SPM. Unpaired t test, paired t test, and multigroup analysis were used on a significance threshold of P < 0.005 (uncorrected) to identify significant differences in rCBF between responders and nonresponders at t1, within both groups over time of treatment (t2–t1), as well as a group x time interactions. Results: Thirty-five patients responded after 4 wk of treatment. Distinct differences between responders and nonresponders were found at the beginning of treatment and also relating to changes in rCBF during treatment. Responders showed a higher posterior cingulate activity at t1. Furthermore, an opposite direction of rCBF changes during treatment could be observed in this area. Conclusion: The differences in rCBF in responders and nonresponders in the posterior cingulate at t1 and the opposite directed changes in rCBF in both groups during treatment in this region suggest that the posterior cingulate function plays a key role in the pathophysiology of depression and may have a predictive value for antidepressive treatment outcome.

Key Words: depression • brain SPECT • SPM • antidepressant treatment