Abstract:
Using positron emission tomography, we studied cerebral glucose
metabolism in drug-free, age- and sex-matched, right-handed patients
with unipolar depression (n 3D 10), bipolar depression (n 3D 10),
obsessive-compulsive disorder (OCD) with secondary depression (n 3D
10), OCD without major depression (n 3D 14), and normal controls (n 3D
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 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 3D 1.05 +/-
0.05; bipolar depression 3D 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 +/- 0.03) 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 3D 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.(ABSTRACT TRUNCATED AT 250 WORDS)