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Association between major depressive symptoms in heart failure and impaired regional cerebral blood flow in the medial temporal region: a study using 99mTc-HMPAO single photon emission computerized tomography (SPECT)

Published online by Cambridge University Press:  06 March 2006

TÂNIA C. T. F. ALVES
Affiliation:
Department of Psychiatry, University of São Paulo Medical School
JAIRO RAYS
Affiliation:
Division of Geriatric Cardiology, Institute of the Heart, University of São Paulo Medical School
RENÉRIO FRÁGUAS JR.
Affiliation:
Department of Psychiatry, University of São Paulo Medical School
MAURICIO WAJNGARTEN
Affiliation:
Division of Geriatric Cardiology, Institute of the Heart, University of São Paulo Medical School
RENATA M. S. TELLES
Affiliation:
Department of Psychiatry, University of São Paulo Medical School
FABIO LUIS DE SOUZA DURAN
Affiliation:
Department of Psychiatry, University of São Paulo Medical School
JOSÉ C. MENEGHETTI
Affiliation:
Section of Radioisotopes, Institute of the Heart, University of São Paulo Medical School
CECIL CHOW ROBILOTTA
Affiliation:
Department of Radiology, University of São Paulo Medical School
SILVANA PRANDO
Affiliation:
Physics Institute, University of São Paulo, São Paulo, Brazil
CLÁUDIO CAMPI DE CASTRO
Affiliation:
Physics Institute, University of São Paulo, São Paulo, Brazil
CARLOS A. BUCHPIGUEL
Affiliation:
Department of Radiology, University of São Paulo Medical School
GERALDO F. BUSATTO
Affiliation:
Department of Psychiatry, University of São Paulo Medical School

Abstract

Background and purpose. Depressive symptoms are frequently associated with heart failure (HF), but the brain mechanisms underlying such association are unclear. We hypothesized that the presence of major depressive disorder (MDD) emerging after the onset of HF would be associated with regional cerebral blood flow (rCBF) abnormalities in medial temporal regions previously implicated in primary MDD, namely the hippocampus and parahippocampal gyrus.

Method. Using 99mTc-SPECT, we measured rCBF in 17 elderly MDD-HF patients, 17 non-depressed HF patients, and 18 healthy controls, matched for demographic variables. Group differences were investigated with Statistical Parametric Mapping.

Results. Significant rCBF reductions in MDD-HF patients relative to both non-depressed HF patients and healthy controls were detected in the left anterior parahippocampal gyrus and hippocampus (ANOVA, p=0·008 corrected for multiple comparisons) and the right posterior hippocampus and parahippocampal gyrus (p=0·005 corrected). In the overall HF group, there was a negative correlation between the severity of depressive symptoms and rCBF in the right posterior hippocampal/parahippocampal region (p=0·045 corrected).

Conclusions. These findings are consistent with the notion that the medial temporal region is vulnerable to brain perfusion deficits associated with HF, and provide evidence that such functional deficits may be specifically implicated in the pathophysiology of MDD associated with HF.

Type
Original Article
Copyright
2006 Cambridge University Press

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Association between major depressive symptoms in heart failure and impaired regional cerebral blood flow in the medial temporal region: a study using 99mTc-HMPAO single photon emission computerized tomography (SPECT)
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Association between major depressive symptoms in heart failure and impaired regional cerebral blood flow in the medial temporal region: a study using 99mTc-HMPAO single photon emission computerized tomography (SPECT)
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Association between major depressive symptoms in heart failure and impaired regional cerebral blood flow in the medial temporal region: a study using 99mTc-HMPAO single photon emission computerized tomography (SPECT)
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