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J Neurol Neurosurg Psychiatry. 1992 September; 55(9): 768–773.
PMCID: PMC1015099

Regional cerebral blood flow abnormalities in depressed patients with cognitive impairment.

Abstract

Depression with cognitive impairment, so called depressive pseudodementia, is commonly mistaken for a neurodegenerative dementia. Using positron emission tomography (PET) derived measures of regional cerebral blood flow (rCBF) a cohort of 33 patients with major depression was studied. Ten patients displayed significant and reversible cognitive impairment. The patterns of rCBF of these patients were compared with a cohort of equally depressed non-cognitively impaired depressed patients. In the depressed cognitively impaired patients a profile of rCBF abnormalities was identified consisting of decreases in the left anterior medial prefrontal cortex and increases in the cerebellar vermis. These changes were additional to those seen in depression alone and are distinct from those described in neurodegenerative dementia. The cognitive impairment seen in a proportion of depressed patients would seem to be associated with dysfunction of neural systems distinct from those implicated in depression alone or the neurodegenerative dementias.

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Selected References

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  • KILOH LG. Pseudo-dementia. Acta Psychiatr Scand. 1961;37:336–351. [PubMed]
  • Reding M, Haycox J, Blass J. Depression in patients referred to a dementia clinic. A three-year prospective study. Arch Neurol. 1985 Sep;42(9):894–896. [PubMed]
  • Marsden CD, Harrison MJ. Outcome of investigation of patients with presenile dementia. Br Med J. 1972 Apr 29;2(5808):249–252. [PMC free article] [PubMed]
  • Nott PN, Fleminger JJ. Presenile dementia: the difficulties of early diagnosis. Acta Psychiatr Scand. 1975 Mar;51(3):210–217. [PubMed]
  • Ron MA, Toone BK, Garralda ME, Lishman WA. Diagnostic accuracy in presenile dementia. Br J Psychiatry. 1979 Feb;134:161–168. [PubMed]
  • Kendell RE. The stability of psychiatric diagnosis. Br J Psychiatry. 1974 Apr;124(0):352–356. [PubMed]
  • Rabins PV, Merchant A, Nestadt G. Criteria for diagnosing reversible dementia caused by depression: validation by 2-year follow-up. Br J Psychiatry. 1984 May;144:488–492. [PubMed]
  • Baxter LR, Jr, Schwartz JM, Phelps ME, Mazziotta JC, Guze BH, Selin CE, Gerner RH, Sumida RM. Reduction of prefrontal cortex glucose metabolism common to three types of depression. Arch Gen Psychiatry. 1989 Mar;46(3):243–250. [PubMed]
  • Endicott J, Spitzer RL. A diagnostic interview: the schedule for affective disorders and schizophrenia. Arch Gen Psychiatry. 1978 Jul;35(7):837–844. [PubMed]
  • Hachinski VC, Iliff LD, Zilhka E, Du Boulay GH, McAllister VL, Marshall J, Russell RW, Symon L. Cerebral blood flow in dementia. Arch Neurol. 1975 Sep;32(9):632–637. [PubMed]
  • HAMILTON M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960 Feb;23:56–62. [PMC free article] [PubMed]
  • Roth M, Tym E, Mountjoy CQ, Huppert FA, Hendrie H, Verma S, Goddard R. CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry. 1986 Dec;149:698–709. [PubMed]
  • Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. [PubMed]
  • Frackowiak RS, Lenzi GL, Jones T, Heather JD. Quantitative measurement of regional cerebral blood flow and oxygen metabolism in man using 15O and positron emission tomography: theory, procedure, and normal values. J Comput Assist Tomogr. 1980 Dec;4(6):727–736. [PubMed]
  • Friston KJ, Frith CD, Liddle PF, Dolan RJ, Lammertsma AA, Frackowiak RS. The relationship between global and local changes in PET scans. J Cereb Blood Flow Metab. 1990 Jul;10(4):458–466. [PubMed]
  • Friston KJ, Frith CD, Liddle PF, Frackowiak RS. Comparing functional (PET) images: the assessment of significant change. J Cereb Blood Flow Metab. 1991 Jul;11(4):690–699. [PubMed]
  • Mathew RJ, Meyer JS, Francis DJ, Semchuk KM, Mortel K, Claghorn JL. Cerebral blood flow in depression. Am J Psychiatry. 1980 Nov;137(11):1449–1450. [PubMed]
  • Warren LR, Butler RW, Katholi CR, McFarland CE, Crews EL, Halsey JH., Jr Focal changes in cerebral blood flow produced by monetary incentive during a mental mathematics task in normal and depressed subjects. Brain Cogn. 1984 Jan;3(1):71–85. [PubMed]
  • Gur RE, Skolnick BE, Gur RC, Caroff S, Rieger W, Obrist WD, Younkin D, Reivich M. Brain function in psychiatric disorders. II. Regional cerebral blood flow in medicated unipolar depressives. Arch Gen Psychiatry. 1984 Jul;41(7):695–699. [PubMed]
  • Sackeim HA, Prohovnik I, Moeller JR, Brown RP, Apter S, Prudic J, Devanand DP, Mukherjee S. Regional cerebral blood flow in mood disorders. I. Comparison of major depressives and normal controls at rest. Arch Gen Psychiatry. 1990 Jan;47(1):60–70. [PubMed]
  • Post RM, DeLisi LE, Holcomb HH, Uhde TW, Cohen R, Buchsbaum MS. Glucose utilization in the temporal cortex of affectively ill patients: positron emission tomography. Biol Psychiatry. 1987 May;22(5):545–553. [PubMed]
  • Gilman S, Adams K, Koeppe RA, Berent S, Kluin KJ, Modell JG, Kroll P, Brunberg JA. Cerebellar and frontal hypometabolism in alcoholic cerebellar degeneration studied with positron emission tomography. Ann Neurol. 1990 Dec;28(6):775–785. [PubMed]
  • Jacobson S, Trojanowski JQ. Prefrontal granular cortex of the rhesus monkey. I. Intrahemispheric cortical afferents. Brain Res. 1977 Aug 26;132(2):209–233. [PubMed]
  • Heath RG, Harper JW. Ascending projections of the cerebellar fastigial nucleus to the hippocampus, amygdala, and other temporal lobe sites: evoked potential and histological studies in monkeys and cats. Exp Neurol. 1974 Nov;45(2):268–287. [PubMed]
  • Reiman EM, Raichle ME, Robins E, Mintun MA, Fusselman MJ, Fox PT, Price JL, Hackman KA. Neuroanatomical correlates of a lactate-induced anxiety attack. Arch Gen Psychiatry. 1989 Jun;46(6):493–500. [PubMed]
  • Lippmann S, Manshadi M, Baldwin H, Drasin G, Rice J, Alrajeh S. Cerebellar vermis dimensions on computerized tomographic scans of schizophrenic and bipolar patients. Am J Psychiatry. 1982 May;139(5):667–668. [PubMed]
  • Courchesne E, Yeung-Courchesne R, Press GA, Hesselink JR, Jernigan TL. Hypoplasia of cerebellar vermal lobules VI and VII in autism. N Engl J Med. 1988 May 26;318(21):1349–1354. [PubMed]
  • Decety J, Sjöholm H, Ryding E, Stenberg G, Ingvar DH. The cerebellum participates in mental activity: tomographic measurements of regional cerebral blood flow. Brain Res. 1990 Dec 10;535(2):313–317. [PubMed]
  • Watson PJ. Nonmotor functions of the cerebellum. Psychol Bull. 1978 Sep;85(5):944–967. [PubMed]
  • Leiner HC, Leiner AL, Dow RS. Does the cerebellum contribute to mental skills? Behav Neurosci. 1986 Aug;100(4):443–454. [PubMed]
  • Frackowiak RS, Pozzilli C, Legg NJ, Du Boulay GH, Marshall J, Lenzi GL, Jones T. Regional cerebral oxygen supply and utilization in dementia. A clinical and physiological study with oxygen-15 and positron tomography. Brain. 1981 Dec;104(Pt 4):753–778. [PubMed]

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