| Background: Major depressive disorder?MDD?is a common mental disorder worldwide,and can lead to suicide.Unfortunately,fewer than 10% MDD sufferers have ever received effective treatments,and one of the most significant barriers is lack of effective assessment and management of MDD.In this study,we used 99mTc-ECD SPECT/CT to characterize the regional cerebral blood flow?r CBF?status of MDD patients,and to explore an objective image assessment model of MDD which is noninvasive,convenient and accurate in a clinical setting.Methods: 74 unipolar MDD patients were enrolled in this study.The severity of MDD was assessed by three trained psychiatrists,based on scores obtained from HAMD and Hamilton Rating Scale for Anxiety?HAMA?.99mTc-ECD r CBF SPECT/CT was performed in 20 healthy controls and 74 unipolar MDD patients before receiving the treatment.The CT attenuation-corrected SPECT data of MDD patients were automatically registered,analyzed and compared with a normalized database using 3D-SSP.An additional quantitative analysis was performed in three targeted areas?caudate nucleus,globus pallidus and hippocampus?.We summarize the abnormal r CBF in MDD,analyzed the gender differences and the differences of marital status in the score of HAMD,and assessed the relationship among the score of HAMD,the score of HAMA,the age of MDD patients,the duration of MDD and the number of years for education.Results: The mean score for the HAMD in the MDD patients was 25.49±6.00,and the score for HAMA was 23.12±5.83.There was a positive correlation between two scores?r=0.732,p=0.000?.But the score of HAMD showed no correlations with the ages of MDD patients?r=0.134,p=0.255?,the duration of MDD?r=-0.140,p=0.235?or the number of years for education?r=-0.195,p=0.096?.Besides,the MDD women?26.66±5.11?had higher HAMD scores than the MDD men?22.52±7.08,t=2.801,p=0.007?.And there was no significant difference in the score of HAMD between married people and non-divorced singles?t=0.436,p=0.664?.Among many brain regions with abnormal z-score,left ventral anterior cingulate cortex B24,left inferior prefrontal gyrus B47,right associative visual cortex B19 and right retrosplenial cortex B29 showed a correlationship with the score of HAMD?R=0.423,F=3.752,p=0.008?.Conclusion: Blood flow abnormalities were found in multiple brain areas of MDD patients.Although the mechanism underlying the correlation is not yet fully understood,our findings indicated that r CBF alterations in the DMN of the brain may be associated with depression severity.The r CBF SPECT/CT may provide an objective assessment for MDD severity.And it might be used identifying MDD endophenotypes and monitoring therapeutic efficacy in the management of MDD. |
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