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Effect of dialysis on cerebral blood flow in depressive end-stage renal disease patients

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Abstract

Objective

The aim of this study was to investigate regional cerebral blood flow (rCBF) changes of end-stage renal disease (ESRD) patients with depressive symptoms during dialysis.

Methods

Fourteen patients with ESRD underwent Tc-99m ethylcysteinate dimer (Tc-99m ECD) brain single photon emission computed tomography (SPECT) and were evaluated the severity of depressive mood at pre-dialytic period and at least 6 months after dialysis initiation. rCBF was analyzed using statistical parametric mapping (SPM) in brain SPECT image. The responder was defined as a decrease of ≥25% in Hamilton Depression Rating Scale (HDRS) score from baseline HDRS score.

Results

Pre-dialysis brain SPECT did not show any rCBF differences between responders and non-responders. The follow-up brain SPECT revealed a significant higher perfusion in left middle temporal gyrus of responder group when compared with non-responder (hemisphere coordinate X, Y, Z; −58, −2, −16, peak Z = 3.36, p = 0.046). In responder, a significant increase in rCBF was found in right parahippocampal gyrus (hemisphere coordinate X, Y, Z; 30, −40, −14, peak Z = 3.51, p = 0.043). In non-responder, there were significant decreases in rCBF in left superior frontal gyrus (hemisphere coordinate X, Y, Z; −22, 30, 42, peak Z = 3.86, p = 0.032) and right orbitofrontal cortex (hemisphere coordinate X, Y, Z; 10, 58, −6, peak Z = 3.81, p = 0.046).

Conclusion

The present findings showed the characteristic patterns of rCBF changes in depressive ESRD patients having maintenance dialysis. Further investigations in brain blood flow and glucose metabolism are needed to elucidate the effect of dialysis itself and the difference of according to dialysis modality in patients having depression and ESRD.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Pusan National University Hospital and Medical Research Institute, Pusan National University, Busan, Republic of Korea

    Hyun-Yeol Nam, Seong-Jang Kim, In Joo Kim, Bum Soo Kim, Kyoungjune Pak & Yong-Ki Kim

  2. Medical Research Institute, Pusan National University, Busan, Republic of Korea

    Sang Heon Song, Seong-Jang Kim, Ihm Soo Kwak, In Joo Kim, Soo Bong Lee, Dong Won Lee & Yong-Ki Kim

  3. Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea

    Sang Heon Song, Ihm Soo Kwak, Soo Bong Lee & Dong Won Lee

  4. Department of Medicine, Pusan National University School of Medicine, Busan, Republic of Korea

    Hyun Sil Yun

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  1. Hyun-Yeol Nam
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Correspondence to Seong-Jang Kim.

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Nam, HY., Song, S.H., Kim, SJ. et al. Effect of dialysis on cerebral blood flow in depressive end-stage renal disease patients. Ann Nucl Med 25, 165–171 (2011). https://doi.org/10.1007/s12149-010-0440-4

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  • DOI: https://doi.org/10.1007/s12149-010-0440-4

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