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Journal ArticleDOI

Reduction of prefrontal cortex glucose metabolism common to three types of depression.

01 Mar 1989-Archives of General Psychiatry (American Medical Association)-Vol. 46, Iss: 3, pp 243-250
TL;DR: Using positron emission tomography, cerebral glucose metabolism in drug-free, age- and sex-matched, right-handed patients with unipolar depression, bipolar depression, obsessive-compulsive disorder (OCD) with secondary depression, OCD without major depression, and normal controls is studied.
Abstract: • Using positron emission tomography, we studied cerebral glucose metabolism in drug-free, age- and sex-matched, righthanded patients with unipolar depression (n =10), bipolar depression (n =10), obsessive-compulsive disorder (OCD) with secondary depression (n =10), OCD without major depression (n =14), and normal controls (n =12). Depressed patients were matched for depression on the Hamilton Depression Rating Scale, and subjects with OCD without depression and OCD with depression had similar levels of OCD pathology. We also studied six non—sex-matched patients with mania. Mean ( ± SD) glucose metabolic rates for the left dorsal anterolateral prefrontal cortex, divided by the rate for the ipsilateral hemisphere as a whole (ALPFC/hem), were similar in the primary depressions (unipolar depression = 1.05 ±0.05; bipolar depression =1.04 ± 0.05), and were significantly lower than those in normal controls (1.12 ± 0.06) or OCD without depression (1.15 ± 0.05). Results for the right hemisphere were similar. Values in subjects with OCD with depression (1.10 0.05) were also significantly lower than in subjects with OCD without depression, and values in subjects with bipolar depression were lower than those in manic subjects (1.12 ± on this measure in the left hemisphere, although results were not significant in the right hemisphere. There was a significant correlation between the HAM-D score and the left ALPFC/hem. With medication for depression (n =12), the left ALPFC/hem increased significantly and the percentage change in the Hamilton scale score correlated with the percentage change in the left ALPFC/hem. These data support other findings that major depression is associated with a left ALPFC abnormality.
Citations
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Journal ArticleDOI
24 Apr 1997-Nature
TL;DR: Using positron emission tomographic images of cerebral blood flow and rate of glucose metabolism to measure brain activity, an area of abnormally decreased activity is localized in the pre-frontal cortex ventral to the genu of the corpus callosum in both familial bipolar depressives and familial unipolar depressives.
Abstract: Pathological disturbances of mood may follow a 'bipolar' course, in which normal moods alternate with both depression and mania, or a 'unipolar' course, in which only depression occurs. Both bipolar and unipolar disorders can be heritable illnesses associated with neurochemical, neuroendocrine and autonomic abnormalities. The neurobiological basis for these abnormalities has not been established. Using positron emission tomographic (PET) images of cerebral blood flow and rate of glucose metabolism to measure brain activity, we have now localized an area of abnormally decreased activity in the prefrontal cortex ventral to the genu of the corpus callosum in both familial bipolar depressives and familial unipolar depressives. This decrement in activity was at least partly explained by a corresponding reduction in cortical volume, as magnetic resonance imaging (MRI) demonstrated reductions in the mean grey matter volume in the same area of 39 and 48% in the bipolar and unipolar samples, respectively. This region has previously been implicated in the mediation of emotional and autonomic responses to socially significant or provocative stimuli, and in the modulation of the neurotransmitter systems targeted by antidepressant drugs.

2,575 citations

Journal ArticleDOI
TL;DR: Reciprocal changes involving subgenual cingulate and right prefrontal cortex occur with both transient and chronic changes in negative mood, suggesting that these regional interactions are obligatory and probably mediate the well-recognized relationships between mood and attention seen in both normal and pathological conditions.
Abstract: OBJECTIVE: Theories of human behavior from Plato to Freud have repeatedly emphasized links between emotion and reason, a relationship now commonly attributed to pathways connecting phylogenetically “old” and “new” brain regions. Expanding on this theory, this study examined functional interactions between specific limbic and neocortical regions accompanying normal and disease-associated shifts in negative mood state. METHOD: Regions of concordant functional change accompanying provocation of transient sadness in healthy volunteers and resolution of chronic dysphoric symptoms in depressed patients were examined with two positron emission tomography techniques: [15O]water and [18F]fluorodeoxyglucose, respectively. RESULTS: With sadness, increases in limbic-paralimbic blood flow (subgenual cingulate, anterior insula) and decreases in neocortical regions (right dorsolateral prefrontal, inferior parietal) were identified. With recovery from depression, the reverse pattern, involving the same regions, was seen—...

2,278 citations


Cites result from "Reduction of prefrontal cortex gluc..."

  • ...Such decreases are nonetheless comparable to those repeatedly described in resting-state studies of patients with clinical depression (26, 42)....

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  • ...These pretreatment abnormalities have been linked to both severity of depression and impairments in psychomotor speed and cognition (26, 30, 42) and are consistent with the direction of cortical changes seen during acute sadness in experiment 1....

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Journal ArticleDOI
TL;DR: The enhanced induction and prolonged expression of BDNF in response to chronic ECS and antidepressant drug treatments could promote neuronal survival, and protect neurons from the damaging effects of stress.
Abstract: The influence of chronic electroconvulsive seizure (ECS) or antidepressant drug treatments on expression of brain-derived neurotrophic factor (BDNF) and its receptor, trkB, was examined by in situ hybridization and Northern blot. In frontal cortex, acute ECS increased BDNF mRNA approximately twofold, an effect significantly augmented by a prior course of chronic ECS treatment (10 d). In the hippocampus, the influence of chronic ECS varied between the major subfields. In the dentate gyrus granule cell layer, chronic ECS decreased the acute induction of BDNF and trkB mRNA by approximately 50%, but prolonged their expression: levels remained elevated two- to threefold 18 hr later after the last chronic ECS treatment, but returned to control 18 hr after acute ECS. In CA3 and CA1 pyramidal cell layers, chronic ECS significantly elevated the acute induction of BDNF, and tended to prolong the expression of BDNF and trkB mRNA. A similar effect was observed in layer 2 of the piriform cortex, where chronic ECS significantly increased the acute induction and prolonged the expression of BDNF and trkB mRNA. Chronic (21 d), but not acute (1 d), administration of several different antidepressant drugs, including tranylcypromine, sertraline, desipramine, or mianserin, significantly increased BDNF mRNA and all but mianserin increased trkB mRNA in hippocampus. In contrast, chronic administration of nonantidepressant psychotropic drugs, including morphine, cocaine, or haloperidol, did not increase levels of BDNF mRNA. Furthermore, chronic administration of ECS or antidepressant drugs completely blocked the down-regulation of BDNF mRNA in the hippocampus in response to restraint stress. The enhanced induction and prolonged expression of BDNF in response to chronic ECS and antidepressant drug treatments could promote neuronal survival, and protect neurons from the damaging effects of stress.

2,077 citations

Journal ArticleDOI
TL;DR: It is suggested that distinct patterns of structural and functional abnormalities in neural systems important for emotion processing are associated with specific symptoms of schizophrenia and bipolar and major depressive disorder.

1,662 citations


Cites background or result from "Reduction of prefrontal cortex gluc..."

  • ...…treatment has been associated predominantly with increased metabolism and blood flow within dorsomedial and dorsolateral prefrontal cortices (Baxter et al 1989; Brody et al 1999; Buchsbaum et al 1997; Kennedy et al 2001; Mayberg et al 1999, 2000) and the dorsal anterior cingulate gyrus…...

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  • ...In this critical review, we have examined the evidence from studies employing a variety of techniques for the presence of specific abnormalities in these systems in major psychiatric illnesses, including schizophrenia, bipolar disorder, and major depressive disorder....

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  • ...…with healthy volunteers, executive task performance and at-rest studies have demonstrated reduced metabolism in dorsolateral and dorsomedial prefrontal cortical regions (Baxter et al 1989; Ketter et al 2001) but increased metabolism within the right amygdala and thalamus (Ketter et al 2001)....

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  • ...…in patients during a major depressive episode reductions in metabolism and blood flow within dorsomedial and dorsolateral prefrontal cortices (Baxter et al 1989; Bench et al 1993; Buchsbaum et al 1997; Soares and Mann 1997) but increased metabolism and blood flow within the ventrolateral…...

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  • ...In the few studies examining neural correlates of task performance in euthymic patients, findings indicate fewer functional neuroanatomic abnormalities compared with symptomatic patients during executive task performance (Baxter et al 1989; Blumberg et al 1999, 2000)....

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Journal ArticleDOI
TL;DR: It is proposed that cerebrovascular disease may predispose, precipitate, or perpetuate some geriatric depressive syndromes and the hypothesis is supported by the comorbidity of depression, vascular disease, and vascular risk factors and the association of ischemic lesions to distinctive behavioral symptoms.
Abstract: We propose that cerebrovascular disease may predispose, precipitate, or perpetuate some geriatric depressive syndromes. The "vascular depression" hypothesis is supported by the comorbidity of depression, vascular disease, and vascular risk factors and the association of ischemic lesions to distinctive behavioral symptoms. Disruption of prefrontal systems or their modulating pathways by single lesions or by an accumulation of lesions exceeding a threshold are hypothesized to be central mechanisms in vascular depression. The vascular depression concept can generate studies of clinical and heuristic value. Drugs used for the prevention and treatment of cerebrovascular disease may be shown to reduce the risk for vascular depression or improve its outcomes. The choice of antidepressants in vascular depression may depend on their effect on neurologic recovery from ischemic lesions. Research can clarify the pathways to vascular depression by focusing on the site of the lesion, the resultant brain dysfunction, the presentation of depression and time of onset, and the contribution of nonbiological factors.

1,625 citations

References
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Journal ArticleDOI
TL;DR: This is an account of further work on a rating scale for depressive states, including a detailed discussion on the general problems of comparing successive samples from a ‘population’, the meaning of factor scores, and the other results obtained.
Abstract: This is an account of further work on a rating scale for depressive states, including a detailed discussion on the general problems of comparing successive samples from a ‘population’, the meaning of factor scores, and the other results obtained. The intercorrelation matrix of the items of the scale has been factor-analysed by the method of principal components, which were then given a Varimax rotation. Weights are given for calculating factor scores, both for rotated as well as unrotated factors. The data for 152 men and 120 women having been kept separate, it is possible to compare the two sets of results. The method of using the rating scale is described in detail in relation to the individual items.

7,977 citations

Journal ArticleDOI
TL;DR: The MRS score correlated highly with an independent global rating, and with scores of two other mania rating scales administered concurrently, and also correlated with the number of days of subsequent stay in hospital.
Abstract: An eleven item clinician-administered Mania Rating Scale (MRS) is introduced, and its reliability, validity and sensitivity are examined. There was a high correlation between the scores of two independent clinicians on both the total score (0.93) and the individual item scores (0.66 to 0.92). The MRS score correlated highly with an independent global rating, and with scores of two other mania rating scales administered concurrently. The score also correlated with the number of days of subsequent stay in hospital. It was able to differentiate statistically patients before and after two weeks of treatment and to distinguish levels of severity based on the global rating.

7,398 citations

Journal ArticleDOI
TL;DR: In this article, a text designed to make multivariate techniques available to behavioural, social, biological and medical students is presented, which includes an approach to multivariate inference based on the union-intersection and generalized likelihood ratio principles.
Abstract: A text designed to make multivariate techniques available to behavioural, social, biological and medical students. Special features include an approach to multivariate inference based on the union-intersection and generalized likelihood ratio principles.

6,488 citations

Book
01 Jan 1976
TL;DR: In this article, a text designed to make multivariate techniques available to behavioural, social, biological and medical students is presented, which includes an approach to multivariate inference based on the union-intersection and generalized likelihood ratio principles.
Abstract: A text designed to make multivariate techniques available to behavioural, social, biological and medical students. Special features include an approach to multivariate inference based on the union-intersection and generalized likelihood ratio principles.

5,807 citations