Wu Joseph C, Gillin J Christian, Buchsbaum Monte S, Schachat Carol, Darnall Lynn A, Keator David B, Fallon James H, Bunney William E
UC Irvine Department of Psychiatry and Human Behavior, Irvine, California 92697-3960, United States.
J Affect Disord. 2008 Apr;107(1-3):181-6. doi: 10.1016/j.jad.2007.07.030. Epub 2007 Nov 26.
This PET study is a continuing investigation of the effects of antidepressant medication and one night of total sleep deprivation on cerebral metabolism in depressed patients. This study was undertaken to confirm previous correlations between symptom improvement ratings and regional changes in glucose metabolism, using a higher resolution scanner than in previous investigations. In addition, we also studied the effect of concomitant antidepressant medication in conjunction with sleep depression.
Six depressed patients were administered the selective serotonin reuptake inhibitor sertraline for a week and then underwent positron emission tomography (FDG PET) before and after sleep deprivation. Changes in relative glucose metabolism were correlated with symptom improvement ratings in Hamilton Depression Rating Scale scores.
Positive correlations (defined as reduced HDRS scores associated with areas having reduced relative cerebral glucose metabolism after TSD) were found in the inferior frontal gyrus and inferior frontal/orbital frontal cortex. Negative correlations (defined as reduced HDRS scores associated with areas of increased relative cerebral glucose metabolism after TSD) were found in the dorsolateral prefrontal cortex.
Limitations of this study are that the number of subjects was small (n=6) and they were scanned at a 7.6 mm resolution.
The results of this study support previous findings on the effects of sleep deprivation and antidepressant medications in the treatment of unipolar and bipolar depression, with an emphasis on the significance of cerebral glucose metabolic changes in the ventral and DLPF cortex in mood regulation.
这项正电子发射断层扫描（PET）研究是对抑郁症患者抗抑郁药物及一晚完全睡眠剥夺对脑代谢影响的持续调查。本研究旨在使用比以往研究更高分辨率的扫描仪，证实先前症状改善评分与葡萄糖代谢区域变化之间的相关性。此外，我们还研究了抗抑郁药物与睡眠剥夺联合使用的效果。
6名抑郁症患者服用选择性5-羟色胺再摄取抑制剂舍曲林一周，然后在睡眠剥夺前后接受正电子发射断层扫描（FDG PET）。相对葡萄糖代谢的变化与汉密尔顿抑郁评定量表（HDRS）评分中的症状改善评分相关。
在额下回和额下/眶额皮质发现正相关（定义为TSD后相对脑葡萄糖代谢降低的区域与HDRS评分降低相关）。在背外侧前额叶皮质发现负相关（定义为TSD后相对脑葡萄糖代谢增加的区域与HDRS评分降低相关）。
本研究的局限性在于受试者数量少（n = 6），且扫描分辨率为7.6毫米。
本研究结果支持先前关于睡眠剥夺和抗抑郁药物在治疗单相和双相抑郁症方面效果的研究发现，强调了腹侧和背外侧前额叶皮质脑葡萄糖代谢变化在情绪调节中的重要性。
