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The anatomy of melancholia – focal abnormalities of cerebral blood flow in major depression

Published online by Cambridge University Press:  09 July 2009

Christopher J. Bench*
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital and School of Medicine; MRC Cyclotron Unit, Hammersmith Hospital; National Hospital for Neurology and Neurosurgery; MRC Human Movement and Balance Unit, London
Karl J. Friston
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital and School of Medicine; MRC Cyclotron Unit, Hammersmith Hospital; National Hospital for Neurology and Neurosurgery; MRC Human Movement and Balance Unit, London
Richard G. Brown
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital and School of Medicine; MRC Cyclotron Unit, Hammersmith Hospital; National Hospital for Neurology and Neurosurgery; MRC Human Movement and Balance Unit, London
Lynette C. Scott
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital and School of Medicine; MRC Cyclotron Unit, Hammersmith Hospital; National Hospital for Neurology and Neurosurgery; MRC Human Movement and Balance Unit, London
Richard S. J. Frackowiak
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital and School of Medicine; MRC Cyclotron Unit, Hammersmith Hospital; National Hospital for Neurology and Neurosurgery; MRC Human Movement and Balance Unit, London
Raymond J. Dolan
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital and School of Medicine; MRC Cyclotron Unit, Hammersmith Hospital; National Hospital for Neurology and Neurosurgery; MRC Human Movement and Balance Unit, London
*
1 Address for correspondence: Dr Christopher J. Bench, MRC Cyclotron Unit, Hammersmith Hospital, DuCane Road, London W12 0HS.

Synopsis

Using positron emission tomography (PET) and 15Oxygen, regional cerebral blood flow (rCBF) was measured in 33 patients with primary depression, 10 of whom had an associated severe cognitive impairment, and 23 age-matched controls. PET scans from these groups were analysed on a pixel-by-pixel basis and significant differences between the groups were identified on Statistical Parametric Maps (SPMs). In the depressed group as a whole rCBF was decreased in the left anterior cingulate and the left dorsolateral prefrontal cortex (P < 0·05 Bonferroni-corrected for multiple comparisons). Comparing patients with and without depression-related cognitive impairment, in the impaired group there were significant decreases in rCBF in the left medial frontal gyrus and increased rCBF in the cerebellar vermis (P < 0·05 Bonferroni-corrected). Therefore an anatomical dissociation has been described between the rCBF profiles associated with depressed mood and depression-related cognitive impairment. The pre-frontal and limbic areas identified in this study constitute a distributed anatomical network that may be functionally abnormal in major depressive disorder.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1992

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References

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