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Lewis R. Baxter, Jr, MD; Jeffrey M. Schwartz, MD; Michael E. Phelps, PhD; John C. Mazziotta, MD, PhD; Barry H. Guze, MD; Carl E. Selin, MS; Robert H. Gerner, MD; Ron M. Sumida

Arch Gen Psychiatry. 1989;46(3):243-250.

Abstract
• Using positron emission tomography, we studied cerebral glucose metabolism in drug-free, age- and sex-matched, righthanded patients with unipolar depression (n =10), bipolar depression (n =10), obsessive-compulsive disorder (OCD) with secondary depression (n =10), OCD without major depression (n =14), and normal controls (n =12). Depressed patients were matched for depression on the Hamilton Depression Rating Scale, and subjects with OCD without depression and OCD with depression had similar levels of OCD pathology. We also studied six non—sex-matched patients with mania. Mean ( ± SD) glucose metabolic rates for the left dorsal anterolateral prefrontal cortex, divided by the rate for the ipsilateral hemisphere as a whole (ALPFC/hem), were similar in the primary depressions (unipolar depression = 1.05 ±0.05; bipolar depression =1.04 ± 0.05), and were significantly lower than those in normal controls (1.12 ± 0.06) or OCD without depression (1.15 ± 0.05). Results for the right hemisphere were similar. Values in subjects with OCD with depression (1.10 0.05) were also significantly lower than in subjects with OCD without depression, and values in subjects with bipolar depression were lower than those in manic subjects (1.12 ± on this measure in the left hemisphere, although results were not significant in the right hemisphere. There was a significant correlation between the HAM-D score and the left ALPFC/hem. With medication for depression (n =12), the left ALPFC/hem increased significantly and the percentage change in the Hamilton scale score correlated with the percentage change in the left ALPFC/hem. These data support other findings that major depression is associated with a left ALPFC abnormality.

Author Affiliations
From the Division of Biophysics and Nuclear Medicine, Department of Radiological Sciences and Laboratory of Nuclear Medicine (Drs Baxter, Phelps, and Mazziotta, and Messrs Selin and Sumida), Department of Psychiatry and Biobehavioral Sciences (Drs Baxter, Schwartz, Guze, and Gerner), and Department of Neurology (Dr Mazziotta), UCLA School of Medicine.

Footnotes
Accepted for publication June 30, 1988.

Reprint requests to UCLA Neuropsychiatric Institute, 760 Westwood Plaza, Los Angeles, CA 90024 (Dr Baxter).

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