Study on depression with ~(99)Tc~m-ECD SPECT regional cerebral blood flow imaging before and after acetazolamide test

Objective To observe the regional cerebral blood flow (rCBF) changes with Technetium-99m ethylcysteinate dimer ( 99 Tcm-ECD) single photon emission computed tomography (SPECT) in patients with depressive disorder before and after acetazolamide test and evaluate the patients' regional cerebral vessels reserve capacity. Methods Eighteen unmedicated adult patients fulfilling the CCMD-3 criteria for depressive disorder and 18 age-gender-matched healthy control subjects were included in the study. A initial baseline 99 Tcm-ECD brain SPECT were performed in both patient and control group. Reconstructed slices were evaluated semiquantitively by a semi-automatic rCBF analysis software. Two days later, the patients group was re-evaluated with the same way following taking orally 2 gram acetazolamide tablet for 2 h. Results The depressed patients showed significantly lower rCBF value in bilateral superior and inferior frontal cortex, bilateral anterior and posterior temporal cortex, bilateral parietal cortex, left basal ganglia region compared to those of controls (P0.01). Furthermore, the rCBF of left parietal cortex in depressed patients was significantly lower (P0.01) in comparison with the contralateral side. After acetazolamide stress test, rCBF of the hypoperfusion regions in baseline step were significantly increased (P0.01), but not reached to the normal level of the controls (P0.05). Conclusion The depressed patients showed different degree and position of lower rCBF perfusion regions. Acetazolamide stress test can significantly increase the rCBF of the hypoperfusion regions in baseline.