Resolution of SPECT-determined anterior cerebral hypoperfusion correlated with maintenance ECT-derived improvement in residual symptoms in a case of late-life psychotic depression

Clinical Nuclear Medicine
Kazumasa SuzukiHiroo Matsuoka

Abstract

A 70-year-old widow with recurrent psychotic depression was successfully treated with maintenance electroconvulsive therapy (ECT) for 4 years up to the present. Anterior cerebral hypoperfusion visualized by single photon emission computerized tomography (SPECT) before ECT persisted (second SPECT study 14 days after the last ECT session) despite a response to the first course of acute ECT. Only mild symptoms remained. Relapse occurred 2 weeks after the post-ECT SPECT study. The hypoperfusion improved after response to a second course of acute ECT (per SPECT 5 days after the last ECT session), and perfusion was normalized after 2-year maintenance ECT (per SPECT 14 days after the last ECT session). The normalization coincided with improvement in depressive symptoms remaining after the second course of acute ECT. We speculate that the effectiveness of maintenance ECT might have been in part the result of the improvement in residual symptoms and that resolution of the persistent anterior hypoperfusion, which might underlie medical refractoriness, illness chronicity, and relapse tendency in late-life depression, might have been associated with the improvement in residual symptoms achieved by maintenance ECT.

References

Nov 1, 1992·The British Journal of Psychiatry : the Journal of Mental Science·B K PuriI Singh
Mar 7, 1998·International Journal of Geriatric Psychiatry·A J Flint, S L Rifat
Dec 12, 2001·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·B S MeyersG S Alexopoulos
Nov 19, 2003·Psychiatry Research·Andreas ConcaPeter König

❮ Previous
Next ❯

Citations

Aug 4, 2011·Neuropsychobiology·Georgios PetridesMatthew V Rudorfer
Jul 31, 2013·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Angela Y LiuBenoit H Mulsant

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

Aphasia

Aphasia affects the ability to process language, including formulation and comprehension of language and speech, as well as the ability to read or write. Here is the latest research on aphasia.