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The British Journal of Psychiatry (2004) 184: 306-311
© 2004 The Royal College of Psychiatrists

Prognostic value of frontal functional neuroimaging in late-onset severe major depression

VÍCTOR NAVARRO, MD, PhD and CRISTÓBAL GASTÓ, MD, PhD

Clinical Institute of Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain

FRANCISCO LOMEÑA, MD, PhD

Department of Nuclear Medicine, Hospital Clinic, Barcelona, Spain

XAVIER TORRES, PsyD

Clinical Institute of Psychiatry and Psychology, Hospital Clinic, Barcelona

JOSÉ J. MATEOS, MD

Department of Nuclear Medicine, Hospital Clinic

MARIÍA J. PORTELLA, PsyD, GUILLEM MASANA, MD, PhD and TEODORO MARCOS, PsyD, PhD

Clinical Institute of Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain

Correspondence: Dr Víctor Navarro, Hospital Clínic, Departamento de Psiquiatría, Villarroel 170, 08036 Barcelona, Spain. Tel: 343 2275477; fax: 343 2275477; e-mail: 30739vno{at}comb.es

Declaration of interest None.

Background There is growing evidence of a relationship between frontal neuroimaging and neuropsychological abnormalities and the physiopathology and course of late-onset major depression.

Aims To assess acute antidepressant response in late-onset major depression in relation to baseline frontal perfusion ratios.

Method A 99mTc HMPAO single photon emission computed tomographic brain scan was performed in medication-free patients with late-onset major depression, who were then included in a 12-week antidepressant treatment regimen. Logistic regression was used to define a predictive model of non-remission.

Results A total of 47 patients completed the study, 34 of whom were classed as remitters and13 as non-remitters. The variable left anterior fronto-cerebellar perfusion ratio had a global predictive power of 87%. Analysing this variable together with the baseline variables age of onset and duration of indexepisode, the predictive power of the model rose to 94%.

Conclusions Our study suggests that a specific frontal functioning could predict the acute antidepressant response in late-onset severe major depression.




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