Correlation between cerebral blood flow and items of the Hamilton Rating Scale for Depression in antidepressant-naive patients

• Published in: Journal of affective disorders 2004-05, Vol.80 (1), p.55-63
• Main Authors: Graff-Guerrero, Ariel, González-Olvera, Jorge, Mendoza-Espinosa, Yazmı́n, Vaugier, Vı́ctor, Garcı́a-Reyna, Juan Carlos
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Amygdala - blood supply; Amygdala - diagnostic imaging; Amygdala - physiopathology; Biological and medical sciences; Brain - blood supply; Brain - diagnostic imaging; Cerebral Cortex - blood supply; Cerebral Cortex - diagnostic imaging; Cerebral Cortex - physiopathology; Cingulate cortex; Cysteine - analogs & derivatives; Depression; Depressive Disorder - diagnosis; Depressive Disorder - diagnostic imaging; Depressive Disorder - physiopathology; Female; Frontal cortex; Frontal Lobe - blood supply; Frontal Lobe - diagnostic imaging; Frontal Lobe - physiopathology; Functional Laterality - physiology; Gyrus Cinguli - blood supply; Gyrus Cinguli - diagnostic imaging; Gyrus Cinguli - physiopathology; Hamilton; Humans; Limbic System - blood supply; Limbic System - diagnostic imaging; Limbic System - physiopathology; Male; Medical sciences; Mood disorders; Organotechnetium Compounds; Psychiatric Status Rating Scales - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regional Blood Flow - physiology; SPECT; SPM99; Tomography, Emission-Computed, Single-Photon - statistics & numerical data
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/S0165-0327(03)00049-1

Background: The purpose of this study was to correlate the basal cerebral blood flow (CBF) in patients with major depressive disorder (MDD) with the score for each of the 21 questions in the Hamilton Rating Scale for Depression (HRSD), in order to determine the cerebral regions associated with each item. Methods: Fourteen antidepressant-naive patients with unipolar depression (DSM-IV criteria for MDD) participated in this study with a HRSD score of ≥20 points. CBF images obtained by SPECT were analyzed by SPM99 software. The significant correlation threshold for a priori regions (frontocortical and limbic regions) was a Z value of at least 2.25 and clusters formed by more than 10 voxels. Results: Items 1, 6, 11 and 20 were positively correlated with right medial frontal gyrus; item 7 was negatively correlated with bilateral medial frontal gyrus. Items 2 and 10 were positively correlated with right anterior and medial cingulate, respectively. Item 5 was negatively correlated with the left amygdala. Item 9 was negatively correlated with bilateral insula, and item 16 with right insula. Items 12 and 14 were positively correlated with right and left precentral frontal gyrus, respectively. Limitations: The small sample size and only out-patients included in the study. Conclusions: The frontal cortex plays an important role in the expression of MDD symptoms. Not all the symptoms evaluated correlated with one single structure, which may explain the diverse results reported in the literature. These preliminary results support the necessity of further analyses by symptoms that could provide more specific information on the pathophysiology of MDD.