Hostname: page-component-8448b6f56d-cfpbc Total loading time: 0 Render date: 2024-04-17T10:28:55.293Z Has data issue: false hasContentIssue false

Depression in Parkinson's Disease

A Positron Emission Study

Published online by Cambridge University Press:  02 January 2018

H. A. Ring*
Affiliation:
Institute of Neurology, London
C. J. Bench
Affiliation:
MRC Cyclotron Unit, London
M. R. Trimble
Affiliation:
Institute of Neurology
D. J. Brooks
Affiliation:
MRC Cyclotron Unit
R. S. J. Frackowiak
Affiliation:
Royal Postgraduate Medical School and MRC Cyclotron Unit
R. J. Dolan
Affiliation:
Royal Free Hospital and MRC Cyclotron Unit
*
Dr Ring, Academic Department of Psychiatry, The London Hospital Medical College, Alexandra Wing, Turner Street, London E1 2AD

Abstract

Background

This study investigated biological correlates of depression in patients with idiopathic Parkinson's disease (PD). We tested the hypothesis that in patients with PD and depression, there was regional dysfunction involving brain areas previously implicated in functional imaging studies of patients with primary depression.

Method

Using positron emission tomographic measurements of regional cerebral blood flow (rCBF), patterns of resting rCBF were measured in ten patiens with PD and major depression, and ten patients with PD alone. The results were compared with findings from ten patients with primary depression and ten normal controls, scanned using identical methods as part of an earlier study. Groups were matched for age, sex and symptom severity.

Results

Bilateral decreases in rCBF were observed in anteromedial regions of the medial frontal cortex and the cingulate cortex (Brodmann's areas (BA) 9 and 32) in the depressed PD group, compared with those with PD alone and compared with normal controls. This regional disturbance overlapped that observed in patients with primary depression.

Conclusions

The findings indicate that the medial prefrontal cortex is a common area of neural dysfunction in the manifestation of both primary depression and depression in PD.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1994 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Bailey, D. L., Jones, T., Friston, K. J., et al (1991) Physical validation of statistical parametric mapping. Journal of Cerebral Blood Flow and Metabolism, 11, 2 (S150).Google Scholar
Baxter, L. R., Schwartz, J. M., Phelps, M. E., et al (1989) Reduction of prefrontal cortex glucose metabolism common to three types of depression. Archives of General Psychiatry, 46, 243250.CrossRefGoogle ScholarPubMed
Bench, C. J., Friston, K. J., Brown, R. G., et al (1992) The anatomy of melancholia – focal abnormalities of cerebral blood flow in major depression and the cognitive impairment of depression. Psychological Medicine, 22, 607615.CrossRefGoogle Scholar
McKeith, I. G., Fairbairn, A. F., et al (1993) Regional cerebral blood flow in depression measured by positron emission tomography: the relationship with clinical dimensions. Psychological Medicine, 23, 579590.Google Scholar
Brooks, D. J., Ibanez, V., Sawle, G. V., et al (1992) Striatal D2 receptor status in patients with Parkinson's disease, striatonigral degeneration, and progressive supranuclear palsy, measured with 11C-raclopride and positron emission tomography. Annals of Neurology, 31, 184192.CrossRefGoogle ScholarPubMed
Brown, R. G. & MacCarthy, B. (1990) Psychiatric morbidity in patients with Parkinson's disease. Psychological Medicine, 20, 7787.CrossRefGoogle ScholarPubMed
Cummings, J. L. (1992) Depression and Parkinson's disease: a review. American Journal of Psychiatry, 149, 443454.Google ScholarPubMed
Fibigier, H. C. (1984) The neurobiological substrates of depression in Parkinson's disease: a hypothesis. Canadian Journal of Neurological Sciences, 11, 105107.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) ‘Minimental state$’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle Scholar
Frackowiak, R. S. J., Lenzi, G-L., Jones, T., et al (1980) Quantitative measurement of regional cerebral blood flow and oxygen metabolism in man using 15O and positron emission tomography: theory, procedure and normal values. Journal of Computer Assisted Tomography, 4, 727736.CrossRefGoogle ScholarPubMed
Friston, K. J., Frith, C. D., Liddle, P. F., et al (1990) The relationship between global and local changes in PET scans. Journal of Cerebral Blood Flow and Metabolism, 10, 458466.CrossRefGoogle ScholarPubMed
Friston, K. J., Frith, C. D., Liddle, P. F., et al (1991) Comparing functional (PET) images: the assessment of significant change. Journal of Cerebral Blood Flow and Metabolism, 11, 690699.CrossRefGoogle ScholarPubMed
Fukunishi, I., Hosokawa, K. & Ozaki, S. (1991) Depression antedating the onset of Parkinson's disease. Japanese Journal of Psychiatry and Neurology, 45, 711.Google ScholarPubMed
Goeders, N. E. & Smith, J. E. (1983) Critical dopaminergic involvement in cocaine reinforcement. Science, 221, 773775.Google Scholar
Hamilton, M. A. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5662.Google Scholar
Hoehn, M. M. & Yahr, M. D. (1967) Parkinsonism: onset, progression and mortality. Neurology, 17, 427442.Google Scholar
Liddle, P. F., Friston, K. J., Frith, C. D., et al (1992) Patterns of cerebral blood flow in schizophrenia. British Journal of Psychiatry, 160, 179186.CrossRefGoogle ScholarPubMed
Marsh, G. G. & Markham, C. H. (1973) Does levodopa alter depression and psychopathology in Parkinsonism patients? Journal of Neurology, Neurosurgery and Psychiatry, 36, 925935.Google Scholar
Mayberg, H. S., Starkstein, S. E., Sadzot, B., et al (1990) Selective hypometabolism in the inferior frontal lobe in depressed patients with Parkinson's disease. Annals of Neurology, 28, 5764.CrossRefGoogle ScholarPubMed
Mayeux, R. (1990) The “serotonin hypothesis” for depression in Parkinson's disease. In Advances in Neurology, Vol. 53. Parkinson's Disease: Anatomy, Pathology and Therapy (eds Streifler, M. B., Korczyn, A. D., Melamed, E., et al), pp. 163166. New York: Raven Press.Google Scholar
Mesulam, M-M. (1986) Frontal cortex behaviour. Annals of Neurology, 19, 320325.CrossRefGoogle Scholar
Spinks, T. J., Jones, T., Gilardi, M. C., et al (1988) Physical performance of the latest generation of commercial positron scanner. IEEE Transactions on Nuclear Science, 35, 721725.CrossRefGoogle Scholar
Starkstein, S. E., Preziosi, T. J., Berthier, M. L., et al (1989) Depression and cognitive impairment in Parkinson's disease. Brain, 112, 11411153.CrossRefGoogle ScholarPubMed
Friston, K. J., Frith, C. D., Liddle, P. F., Bolduc, P. L., et al (1990) Depression in Parkinson's disease. Journal of Nervous and Mental Disease, 178, 2731.Google Scholar
Talairach, J. & Tournoux, P. (1988) Co-planar Stereotaxic Atlas of the Human Brain. Stuttgart: George Thieme Verlag.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.