Reduction of Cerebral Blood Flow in Older Depressed Patients

doi:10.1001/archpsyc.1994.03950090009002

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Vol. 51 No. 9, September 1994

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Reduction of Cerebral Blood Flow in Older Depressed Patients

Ira M. Lesser, MD; Ismael Mena, MD; Kyle B. Boone, PhD; Bruce L. Miller, MD; C. Mark Mehringer, MD; Marcy Wohl, RN

Arch Gen Psychiatry. 1994;51(9):677-686.

Abstract

Background
We investigated regional cerebral blood flow in older, drug-freedepressed patients and examined factors that might be relatedto rCBF.

Methods
We studied 39 physically healthy depressed patients over theage of 50 years and 20 psychiatrically healthy control subjects.Regional cerebral blood flow was measured with single photonemission computed tomography, using both xenon 133 (to quantifyregional cerebral blood flow) and ^99mTc-hexamethylpropyleneamine oxime (to make regional comparisons). From magnetic resonanceimaging, we derived a semiquantitative measure of areas of whitematter hyperintensity and a ventricle-to-brain ratio.

Results
Patients exhibited a global reduction in regional cerebral bloodflow compared with controls, with the orbital frontal and inferiortemporal areas affected bilaterally. Regional cerebral bloodflow was also reduced in higher brain slices in the right butnot the left hemisphere. Significant predictors of lowered regionalcerebral blood flow were being depressed, being male, and havinga greater ventricle-to-brain ratio. There appeared to be a subgroupof patients who demonstrated large areas of white matter hyperintensityand low regional cerebral blood flow.

Conclusions
Cerebral blood flow was lower in older, medication-free depressedpatients than in agematched control subjects, involved the orbitalfrontal and anterior temporal regions, and was more reducedin the right hemisphere.

Author Affiliations

From the Departments of Psychiatry (Drs Lesser and Boone and Ms Wohl), Radiology (Drs Mena and Mehringer), and Neurology (Dr Miller), Harbor-UCLA Medical Center, Torrance, Calif.

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