Right temporal activation differs between melancholia and nonmelancholic depression: a multichannel near-infrared spectroscopy study.

The aim of this study was to determine whether melancholia differs from nonmelancholic depression in frontotemporal functioning by means of multichannel near-infrared spectroscopy. We recruited 32 major depressive disorder (MDD) patients with melancholic features (MDD-MF), 28 MDD patients with nonmelancholic features (MDD-NMF), and 24 healthy controls. Regional hemodynamic changes induced by a verbal fluency task (VFT) were monitored, and their correlations with depressive symptoms were examined. In comparison with the controls, significant differences were observed in mean oxygenated hemoglobin (oxy-Hb) changes induced by VFT in patients with MDD-MF in 25 channels (p = 0.000-0.047) and in those with MDD-NMF in 12 channels (p = 0.000-0.023). Moreover, patients with MDD-MF had significantly smaller mean oxy-Hb changes than those with MDD-NMF in 8 channels of the right temporal region (p = 0.001-0.048). No significant correlations were observed between mean oxy-Hb changes and the Hamilton rating scale for depression (HAMD) 17 total score in both groups of patients with MDD. On examining each item of HAMD17, psychomotor retardation in patients with MDD-MF showed a significant positive correlation with mean oxy-Hb changes in the right temporal region (ch43; ρ = 0.55; p = 0.001), whereas that in patients with MDD-NMF showed a significant negative correlation with mean oxy-Hb changes in the frontal and left temporal regions in 3 channels (ρ = -0.60 to -0.53; p = 0.000-0.004). In conclusion, our results indicate that melancholia is qualitatively distinct from nonmelancholic depression both clinically and biologically.