Kimbrell Tim A, Ketter Terence A, George Mark S, Little John T, Benson Brenda E, Willis Mark W, Herscovitch Peter, Post Robert M
North Little Rock VA Medical Center (TAKi), North Little Rock, Arkansas, USA.
Biol Psychiatry. 2002 Feb 1;51(3):237-52. doi: 10.1016/s0006-3223(01)01216-1.
Patients with unipolar depression are most often reported to have decreased regional cerebral glucose metabolism (rCMRglu) in dorsal prefrontal and anterior cingulate cortices compared with healthy control subjects, often correlating inversely with severity of depression.
We measured rCMRglu with fluorine-18 deoxyglucose positron emission tomography (PET) in 38 medication-free patients with unipolar depression and 37 healthy control subjects performing an auditory continuous performance task to further investigate potential prefrontal and anterior paralimbic rCMRglu abnormalities in patients attending to this task.
Compared with control subjects, the subgroup of patients with Hamilton depression scores of 22 or greater demonstrated decreased absolute rCMRglu in right prefrontal cortex and paralimbic/amygdala regions as well as bilaterally in the insula and temporoparietal cortex (right > left); they also exhibited increased normalized metabolic activity bilaterally in the cerebellum, lingula/cuneus, and brain stem. Severity of depression negatively correlated with absolute rCMRglu in almost the entire extent of the right cingulate cortex as well as bilaterally in prefrontal cortex, insula, basal ganglia, and temporoparietal cortex (right > left).
Areas of frontal, cingulate, insula, and temporal cortex appear hypometabolic in association with different components of the severity and course of illness in treatment-resistant unipolar depression.
与健康对照者相比，单相抑郁症患者最常被报道背侧前额叶和前扣带回皮质的局部脑葡萄糖代谢（rCMRglu）降低，且常与抑郁严重程度呈负相关。
我们使用氟-18脱氧葡萄糖正电子发射断层扫描（PET）测量了38例未服用药物的单相抑郁症患者和37例健康对照者在执行听觉连续作业任务时的rCMRglu，以进一步研究参与该任务的患者潜在的前额叶和前边缘旁rCMRglu异常。
与对照者相比，汉密尔顿抑郁量表得分≥22分的患者亚组在右侧前额叶皮质、边缘旁/杏仁核区域以及双侧岛叶和颞顶叶皮质（右侧>左侧）表现出绝对rCMRglu降低；他们在双侧小脑、舌回/楔叶和脑干也表现出标准化代谢活性增加。抑郁严重程度与几乎整个右侧扣带回皮质以及双侧前额叶皮质、岛叶、基底神经节和颞顶叶皮质（右侧>左侧）的绝对rCMRglu呈负相关。
在难治性单相抑郁症中，额叶、扣带回、岛叶和颞叶皮质区域的代谢减退似乎与疾病严重程度和病程的不同组成部分相关。
