Psychiatry Investig.
2010 Sep;7(3):208-214.
Frontal Dysfunction Underlies Depression in Mild Cognitive Impairment: A FDG-PET Study
- Affiliations
-
- 1Department of Neuropsychiatry, College of Medicine, Seoul National University, Seoul, Korea. selfpsy@snu.ac.kr
- 2Department of Interdisciplinary Program for Cognitive Science, College of Medicine, Seoul National University, Seoul, Korea.
- 3Department of Neuropsychiatry, College of Medicine, Soonchunhyang University, Bucheon Hospital, Bucheon, Korea.
- 4Department of Neuropsychiatry, Daerim St. Mary's Hospital, Seoul, Korea.
- 5Department of Neuropsychiatry, College of Medicine, Seoul National University, Bundang Hospital, Seongnam, Korea.
Abstract
OBJECTIVE
Depression is a very common symptom in people with mild cognitive impairment (MCI), a preclinical stage of Alzheimer's disease (AD), and in those with clinically evident AD. Moreover, MCI individuals with depression show a higher conversion rate to clinical AD than those without depression. This study aimed to elucidate the functional neuroanatomical substrate of depression in MCI.
METHODS
Thirty-six patients were recruited from a University Hospital-based cohort; 18 of these subjects had MCI with depression (MCI_D); the remaining 18 subjects were age- and gender-matched, and had MCI with no depression (MCI_ND). For comparison, 16 cognitively normal (CN) elderly individuals were also included. All subjects underwent Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) scanning and regional cerebral glucose metabolism was compared among the three groups by a voxel-based method. The relationship between severity of depression, as measured by Hamilton Rating Scale for Depression (HRSD) scores, and glucose metabolism was also investigated.
RESULTS
MCI_D showed lower glucose metabolism in the right superior frontal gyrus than MCI_ND. There was a significant negative correlation between HRSD score and glucose metabolism at the same frontal region for overall MCI subjects. When compared with CN, both MCI_D and MCI_ND showed decreased glucose metabolism in the precuneus, while MCI_D had, in addition, reduced metabolism in other diffuse brain regions.
CONCLUSION
Given previous observations on depression in AD, our results suggest that functional disruption of the frontal region, known to be associated with primary or other secondary depression, underlies depression in preclinical AD as well as clinically evident AD.
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