Kaichi Yoko, Okada Go, Takamura Masahiro, Toki Shigeru, Akiyama Yuji, Higaki Toru, Matsubara Yoshiko, Okamoto Yasumasa, Yamawaki Shigeto, Awai Kazuo
Diagnostic Radiology, Graduate School and Institute of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan.
Department of Psychiatry and Neurosciences, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan.
J Affect Disord. 2016 Apr;194:135-43. doi: 10.1016/j.jad.2015.12.062. Epub 2016 Jan 21.
A few studies have used pseudo-continuous arterial spin labeling (pCASL) to assess the regional cerebral blood flow (rCBF) in patients with major depressive disorder (MDD). However, rCBF changes during treatment with escitalopram have not been studied in detail. We used pCASL to investigate the effect of 6-week escitalopram treatment on the rCBF in MDD patients.
We subjected 53 MDD patients and 36 controls to pCASL (T1, baseline). The patients then received treatment with escitalopram for 6 weeks and 27 were scanned again (T2). We used selected regions of interest that exhibited differences between the controls and patients at T1 and compared the T2 rCBF in the patients with the T1 rCBF of the controls. We also compared the T1 and T2 rCBF in the patients to assess their response to escitalopram.
After 6-week treatment with escitalopram, the rCBF in the patients' left inferior temporal gyri, the middle- and inferior frontal gyri, and the subgenual anterior cingulate, which had been higher at T1 than in the controls, was decreased. Their rCBF in the right lingual gyrus remained significantly lower at T2.
We did not have a placebo-control group and the number of patients available at T2 was small.
In MDD patients, 6-week escitalopram treatment elicited significant rCBF changes toward normalization in most of the areas that had shown significant differences between the patients and the controls at T1. The persistence of rCBF anomalies in the right lingual gyrus may be a trait marker of MDD.
一些研究已使用伪连续动脉自旋标记（pCASL）来评估重度抑郁症（MDD）患者的局部脑血流量（rCBF）。然而，艾司西酞普兰治疗期间rCBF的变化尚未得到详细研究。我们使用pCASL来研究6周艾司西酞普兰治疗对MDD患者rCBF的影响。
我们让53例MDD患者和36名对照者接受pCASL检查（T1，基线）。然后患者接受艾司西酞普兰治疗6周，其中27例再次进行扫描（T2）。我们使用在T1时对照者和患者之间表现出差异的选定感兴趣区域，并将患者的T2 rCBF与对照者的T1 rCBF进行比较。我们还比较了患者的T1和T2 rCBF，以评估他们对艾司西酞普兰的反应。
经过6周的艾司西酞普兰治疗后，患者左颞下回、额中回和额下回以及膝下前扣带回的rCBF在T1时高于对照者，治疗后降低。他们右舌回的rCBF在T2时仍显著低于对照者。
我们没有安慰剂对照组，且T2时可用的患者数量较少。
在MDD患者中，6周的艾司西酞普兰治疗使大多数在T1时患者与对照者之间显示出显著差异的区域的rCBF发生显著变化，趋向于正常化。右舌回rCBF异常的持续存在可能是MDD的一个特质标记。
