Skip to main content
SpringerLink
Log in

Changes in regional cerebral blood flow demonstrated by 99mTc-HMPAO SPECT in euthymic bipolar patients

  • ORIGINAL PAPER
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Single photon emission computed tomography (SPECT) with 99mTc-HMPAO was used to compare regional cerebral blood flow (rCBF) in patients with bipolar disorder and in healthy controls. The sample of this study consisted of 16 euthymic bipolar patients who met the DSM-IV criteria and 10 healthy control subjects. The mean regional cerebral blood flow values of the bipolar euthymic patients were significantly lower than those of the controls in the bilateral medial-basal temporal, occipital; medial frontal; parietal regions and in the cingulate gyrus; the hypoperfusion in the cingulate had the highest significant P value (.001, Bonferroni correction). No significant differences in rCBF emerged between right and left-brain regions. The most important findings of the current study are the presence of regional cerebral perfusion alterations, particularly in the cingulate gyrus in the euthymic bipolar patients. Our results imply that underlying brain dysfunction may be independent from manic or depressive episodes in bipolar disorder. Because of the small number of subjects, however, this finding should be viewed as preliminary.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ketter TA, George MS, Ring HA, Pazzaglia P, Marangell L, Krimbell TA, Post RM (1994) Primary mood disorder: structural and resting functional studies. Psychiatr Ann 24:637–642

    Google Scholar 

  2. Soares JC, Mann JJ (1997) The functional neuroanatomy of mood disorders. J Psychiatr Res 31:393–432

    Article  PubMed  CAS  Google Scholar 

  3. Strakowski SM, DelBello MP, Adler C, Cecil KM, Sax KW (2000) Neuroimaging in bipolar disorder. Bipolar Disord 2:148–164

    Article  PubMed  CAS  Google Scholar 

  4. Drevets WC, Price JL, Simpson JR, Tood RD, Reich T, Vannier M, Raichlem F (1997) Subgenual prefrontal cortex abnormalities in mood disorders. Nature 386:824–827

    Article  PubMed  CAS  Google Scholar 

  5. Bonne O, Krausz Y, Gorfine M, Karger H ,Gelfin Y, Shapira B, Chisin R, Lere B (1996) Cerebral hypoperfusion in medication resistant depressed patients assessed by Tc99m HMPAO SPECT. J Affect Disord 41:163–171

    Article  PubMed  CAS  Google Scholar 

  6. Bearden CE, Hoffman KM, Cannon TD (2001) The neuropsychology and neuroanatomy of bipolar disorder: a critical rewiew. Bipolar Disord 3:106–150

    Article  PubMed  CAS  Google Scholar 

  7. Videbech P (2000) PET measurements of brain glucose metabolism and blood flow in major depressive disorder: a critical review. Acta Psychiatr Scand 1:11–20

    Article  Google Scholar 

  8. Strakowski SM, Delbello MP, Adler CM (2005) The functional neuroanatomy of bipolar disorder: a review of neuroimaging findings. Mol Psychiatry 10:105–116

    Article  PubMed  CAS  Google Scholar 

  9. Gyulai L, Alavi A, Broich K, Reilley J, Ball WB, Whybrow PC (1997) I-123 Iofetamine single-photon compudet emission tomography in rapid cycling bipolar disorder: a clinical study. Biol Psychiatry 41:152–161

    Article  PubMed  CAS  Google Scholar 

  10. First MB, Spitzer RL, Gibbon M, Williams JBW (1997) Structured clinical interview for DSM-IV clinical version (SCID-I/CD). American Psychiatric Press, Washington DC

    Google Scholar 

  11. American Psychiatric Association (1994). DSM IV: diagnostic and statistical manual of mental disorders IV. American Psychiatric Press, Washington, DC

    Google Scholar 

  12. Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62

    Article  PubMed  CAS  Google Scholar 

  13. Bech P, Bolwig TG, Kramp P, Rafaelsen OJ (1979) The Bech-Rafaelsen mania scale and the Hamilton depression scale. Acta Psychiatr Scand 59:420–430

    Article  PubMed  CAS  Google Scholar 

  14. Tan U (1988) The distribution of hand preference in normal men and women. Int J Neurosci 42:85–105

    Article  PubMed  CAS  Google Scholar 

  15. Declaration of Helsinki (1996) World medical organization. Br Med J 313:1448–1449

    Google Scholar 

  16. Camargo EE (2001) Brain SPECT in neurology and psychiatry. J Nucl Med 42:611–623

    PubMed  CAS  Google Scholar 

  17. Catafau A (2001) Brain SPECT in clinical practice. Part I: perfusion. J Nucl Med 42:259–271

    PubMed  CAS  Google Scholar 

  18. Tatsch K, Asenbaum S, Bartenstein P, Catafau A, Haldin C, Pilowsky LS, Pupi A (2002) European Association of Nuclear Medicine. European Association of Nuclear Medicine procedure guidelines for brain perfusion SPET using (99m) Tc- labelled radiopharmaceuticals. Eur J Nucl Med Mol Imaging 29:BP36–BP42

    Article  PubMed  CAS  Google Scholar 

  19. Guerra UP (ed) (1998). Brain SPECT: a normal brain morpho-functional atlas. Gruppoimmagine, Roma

    Google Scholar 

  20. Delvenne V, Delecluse F, Hubain P, Schoustens A, De Maertelaer V, Mendlewicz J (1990) Regional cerebral blood flow in patients with affective disorders. Br J Psychiatry 157:359–365

    Article  PubMed  CAS  Google Scholar 

  21. George MS Ketter TA Post RM (1993) SPECT and PET imaging in mood disorders. J Clin Psychiatry 54 (suppl):6–13

    Google Scholar 

  22. Kennedy SH, Javanmard M, Vaccarino FJ (1997) A revive of functional neuroimaging in mood disorder; positron emission tomography and depression. Can J Psychiatry 42:467–475

    PubMed  CAS  Google Scholar 

  23. Kaur S, Sassi RB, Axelson D (2005) Cingulate cortex anatomical abnormalities in children and adolescents with bipolar disorder. Am J Psychiatry 162:1637–1643

    Article  PubMed  Google Scholar 

  24. Zimmerman ME, DelBello MP, Getz GE, Shear PK, Strakowski SM (2006) Anterior cingulate subregion volumes and executive function in bipolar disorder. Bipolar Disord 8:281–288

    Article  PubMed  Google Scholar 

  25. Benabarre A, Vieta E, Martinez-Aran A, Garcia MG, Martin F, Lomena F, Torrent C, Moreno JS, Colom F, Reinares M, Esteve B, Valdes M (2005) Neuropsychological disturbances and cerebral blood flow in bipolar disorder. Aust N Z J Psychiatry 39:227–234

    Article  PubMed  Google Scholar 

  26. Ito H, Kawashima R, Awata S, Ono S, Sato K, Goto R, Koyama M, Sato M, Fukada H (1996) Hypoperfusion in the limbic system and prefrontal cortex in depression: SPECT with anatomic standardization technique. J Nucl Med 37:410–414

    PubMed  CAS  Google Scholar 

  27. Rubin E, Sackeim HA, Prohovnik I, Moeller JR, Schnur DB, Mukherjee S (1995) Regional cerebral blood flow in mood disorders: IV. Comparison of mania and depression. Psychiatry Res 61:1–10

    Article  PubMed  CAS  Google Scholar 

  28. Rush AJ, Schlesser MA, Stokely E, Bonte FR, Altshuller KZ (1982) Cerebral blood flow in depression and mania. Psychopharmacol Bull 18:6–7

    Google Scholar 

  29. O’Connell RA, Van Heertum RL, Luck D, Yudd AP, Cueva JE, Billick SB, Cordon DJ, Gersh RJ, Masdeu JC (1995) Single photon emission computed tomography of the brain in acute mania and schizophrenia. J Neuroimaging 5:101–104

    PubMed  CAS  Google Scholar 

  30. Goodwin GM, Cavanagh JTO, Glabus MF, Kehoe F, O’carroll RE, Ebmeir KP (1997) Uptake of 99mTc-exametazime shown by single photon emission computed tomography before and after lithium withdrawal in bipolar patients: associations with mania. Br J Psychiatry 170:426–430

    PubMed  CAS  Google Scholar 

  31. Tutus A, Simsek A, Sofuoglu S, Nardali M, Kugu N, Karaaslan F, Gonul AS (1998) Changes in regional cerebral blood flow demonstrated by single photon emission computed tomography in depressive disorders: comparison of unipolar vs. bipolar subtypes. Psychiatry Res 83:169–177

    Article  PubMed  CAS  Google Scholar 

  32. Navarro V, Gasto C Lomena F, Mateos JJ, Marcos T, Portella MJ (2002) Normalization of frontal cerebral perfusion in remitted elderly major depression: a 12-month follow-up SPECT study. NeuroImage 16:781–787

    Article  PubMed  Google Scholar 

  33. Migliorelli R, Sarkstein SE, Teson A (1993) SPECT findings in patients with primer mania. J Neuropsychiatry Clin Neurosci 5:379–387

    PubMed  CAS  Google Scholar 

  34. Stoll AL, Renshaw PF, Yurgelun-Todd A, Cohen BM (2000) Neuroimaging in bipolar disorder: What have we learned? Biol Psychiatry 48:505–517

    Article  PubMed  CAS  Google Scholar 

  35. Altshuler LL, Conrad A, Hauser P, Li X, Guze BH, Denikoff K, Troutellotte W, Post R (1991) Reduction of temporal lobe volume in bipolar disorder: a preliminary report of magnetic resonance imaging. Arch Gen Psychiatry 48:482–483

    PubMed  CAS  Google Scholar 

  36. Holcomb HH, Cascella NG, Thaker GK, Medoff DR, Dannals RF, Tamminga CA (1996) Functional sites of neuroleptic drug action in the human brain: PET/FDG studies with and without haloperidol. Am J Psychiatry 153:41–49

    PubMed  CAS  Google Scholar 

  37. Miller DD, Rezai K, Alliger R, Andreasen NC (1997) The effect of antipsychotic medication on relative cerebral perfusion in schizophrenia: assessment with technetium-99m hexamethyl-propyleneamine oxium single photon emission computed tomography. Biol Psychiatry 41:550–559

    Article  PubMed  CAS  Google Scholar 

  38. Strakowski SM, Adler CM, Holland SK, Mills NP, DelBello MP, Eliassen JC (2005) Abnormal fMRI brain activation in euthymic bipolar disorder patients during a counting stroop interference task. Am J Psychiatry 162:1697–1705

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

This study was supported by Pamukkale University’s Research Fund (No: 2002TPF16).

Author information

Authors and Affiliations

  1. Faculty of Medicine, Psychiatry Department, Pamukkale University, Denizli, Turkey

    Atesci Figen Culha, Ozdel Osman, Karadag Filiz, Oguzhanoglu Nalan Kalkan & Varma Gulfizar

  2. Pamukkale Universitesi, Tıp Fakultesi, Psikiyatri AD, Doktorlar cad, No:42, Denizli, Turkey

    Atesci Figen Culha

  3. Faculty of Medicine, Nuclear Medicine Department, Pamukkale University, Denizli, Turkey

    Yuksel Dogangün & Kırac Suna

  4. Faculty of Medicine, Biostatistical Department, Pamukkale University, Denizli, Turkey

    Akdag Beyza

Authors
  1. Atesci Figen Culha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ozdel Osman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuksel Dogangün
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Karadag Filiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kırac Suna
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Oguzhanoglu Nalan Kalkan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Varma Gulfizar
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Akdag Beyza
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Atesci Figen Culha.

Additional information

This study was presented as an oral presentation in the 7th International Congress of Nuclear Oncology and 18th National Congress of The Turkish Society of Nuclear Medicine 13–17 May 2006, Antalya, Turkey and in the International Conference on Mood Disorders 30 March–1 April 2006 Istanbul, Turkey.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Culha, A.F., Osman, O., Dogangün, Y. et al. Changes in regional cerebral blood flow demonstrated by 99mTc-HMPAO SPECT in euthymic bipolar patients. Eur Arch Psychiatry Clin Neurosc 258, 144–151 (2008). https://doi.org/10.1007/s00406-007-0766-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-007-0766-7

Key words

Search

Navigation