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Studying Brain Blood Flow to Treat Depression




The usefulness of established molecular imaging/nuclear medicine approaches in identifying the "hows" and "whys" of brain dysfunction and its potential in providing immediately useful information in treating depression are emphasized in a study in the August Journal of Nuclear Medicine.



Studying Brain Blood Flow to Treat Depression

"Individuals in a depressed emotional state have impaired cerebral (brain) blood flow," explained Omer Bonne, head of inpatient psychiatry and associate professor in the Department of Psychiatry at Hadassah-Hebrew University Medical Center in Jerusalem, Israel. "Clinical improvement in depression is accompanied by diverse changes in cerebral blood flow, as per whether patients are treated with medicine or electroconvulsive therapy," he noted. "We observed that antidepressant medicines normalized decreased brain blood flow commonly seen in patients with depression, while electroconvulsive therapy was linked to additional decreases in blood flow," he reported. "Currently, clinical psychiatry is based almost solely on subjective observer-based judgment. Our findings suggest that objective imaging evaluations could support subjective clinical decisions," he said.

Using SPECT (single photon emission computed tomography)-a molecular imaging/nuclear medicine procedure in which injected radiotracers are utilized to produce three-dimensional, computer-reconstructed images that reveal information about both structure and function-researchers confirmed already published findings that cerebral blood flow in depressed patients is lower than in healthy control subjects, particularly in frontal, limbic and subcortical brain regions. "We wanted to see whether improvement in clinical depression is accompanied by changes-increases-in cerebral blood flow," he said. "We observed that cerebral blood flow increased only in patients whose depression improved. In contrast, cerebral blood flow remained unchanged in patients whose depressed condition persisted," detailed Bonne.

Depression is a serious and debilitating-yet treatable-disease that affects every aspect of a person's health. Estimates indicate that 19 million Americans are affected by depression each year, along with their family members, friends and co-workers. Depression may be correlation to a chemical imbalance in the brain that makes it hard for the cells to communicate with one another. A variety of antidepressant medications and psychotherapies are used to treat depression. Sometimes electroconvulsive treatment-applying an electric current briefly to produce a seizure-is useful, particularly for those whose depression is severe or life threatening or for whom repeated therapy trials with antidepressant drugs failed.

"Interestingly, patients' response to two different classes of antidepressant medicines that target different neurotransmitters is linked to a similar improvement in cerebral blood flow," he noted. "However, cerebral blood flow continued to deteriorate in patients who responded to electroconvulsive treatment," added Bonne, who helped implement functional brain imaging research in psychiatry at Hadassah. Israeli scientists studied 33 depressed patients and 25 healthy control subjects with SPECT and the radiotracer 99mTc-HMPAO.

"Our findings may aid in elucidating the mechanism of depression and its therapy," said Bonne. "There may be more than one mechanism responsible for the development of depression and for mediating response to its therapy," he added. Additional research could examine whether it's possible to use functional imaging techniques to determine which patients would benefit from drug therapy and which would respond better to electroconvulsive treatment, explained Bonne. Future research should also examine the differences in brain blood flow in patients at later time points, he said.

"99mTc-HMPAO SPECT Study of Cerebral Perfusion After Treatment With Medication and Electroconvulsive Therapy in Major Depression" appears in the recent issue of the Journal of Nuclear Medicine, which is published by SNM, the world's largest molecular imaging and nuclear medicine society. Co-authors include Yoav Kohn and Bernard Lerer, Department of Psychiatry, and Nanette Freedman, Hava Lester, Yodphat Krausz and Roland Chisin, Department of Medical Biophysics and Nuclear Medicine, at Hadassah-Hebrew University Medical Center in Jerusalem, Israel.


Posted by: Daniel    Source




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The usefulness of established molecular imaging/nuclear medicine approaches in identifying the "hows" and "whys" of brain dysfunction and its potential in providing immediately useful information in treating depression are emphasized in a study in the August Journal of Nuclear Medicine.

Medicineworld.org: Studying Brain Blood Flow to Treat Depression

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