Bipolar Bozuklukta Beyin Kan Akımının İncelenmesi: Spect ile Yapılan Karşılaştırmalı Bir Çalışma

Duru Gündoğar; Hüseyin Özsan; Özlem Küçük; Gülseren Aras

doi:10.1501/Kriz_0000000262

Investigation of Brain Blood Flows in Bipolar Disorder: A Comparative Study with Spect

Year 2007, Volume: 15 Issue: 2, 37 - 48, 01.06.2007

Duru Gündoğar Hüseyin Özsan Özlem Küçük Gülseren Aras

https://doi.org/10.1501/Kriz_0000000262

Abstract

Objective: This study was conducted todetermine whether the alteration patterns inregional cerebral blood flow in bipolar disorder,if present, are state dependent and to specifythe trait characteristics , distinguishing patientsfrom controls in terms of cerebral blood flow.Method: The study comprises 50 subjects ofwhich 17 were bipolar manic, 16 bipolar patientsin full remission (with a total of 33 bipolar Ipatients), and 17 healthy volunteers. Thegroups were similar in terms of age and gender.DSM-IV Structured Clinical Interview forDiagnosis of Axis I Disorders was performed toverify the diagnosis of bipolar affective disorder.The control group consisted of healthy volunteers. 99m Tc-HMPAO SPECT was performedfor all of the subjects. The regional cerebralblood flows relative to the cerebellum and to thetotal brain blood flow were maesured. Results:There was no statistically significant differenceregarding the brain blood flows in any of themeasures between mania and remissiongroups. The control group was statistically different from the bipolar I group, the most prominent alterations being in the right temporal lobeand the anterior-posterior gradient.Conclusion: In order to apply these data forclinical use, further controlled studies with larger patient groups are required

Keywords

Bipolar disorder, mania, SPECT

References

Al-Mousawi AH, Evans N, Ebmeier KP ve ark. (1996) Limbic Dysfunction in Schizophrenia and Mania: A Study Using F-Labelled Fluorodeoxyglu- cose and Positron Emission Tomography. Br J Psychiatry;169: 509-516.
Baxter LR Jr, Schwartz JM, Phelps ME ve ark. (1989) Reduction of Prefrontal Cortex Glucose Metabolism Common to Three Types of Depression. Arch Gen Psychiatry 46: 243-250.
Bearden CE, Hoffman KM, Cannon TD (2001) The Neuropsychology and Neuroanatomy of Bipolar Affective Disorder: A Critical Review. Bipolar Disord; 3(3): 106-150.
Blumberg HP, Stern E, Martinez D ve ark. (2000) Increased Anterior Cingulate and Caudate Activity in Bipolar Mania. Biol Psychiatry; 48: 1045- 1052.
Costa D, Ell PJ (1992) Brain Blood Flow in Neurology and Psychiatry. Churchill Livingstone Inc, London.
Çorapçıoğlu A, Aydemir Ö, Yıldız M ve ark. (1999) DSM-IV Yapılandırılmış Klinik Görüşmesi Türkçe Versiyonu. Hekimler Yayın Birliği, Bilkent, Ankara.
Devous MD, Rush AJ, Schlesser MA ve ark. (1984) Single Photon Tomographic Determination of Regional Cerebral Blood Fow in Psychiatric Disorders. J Nucl Med; 25: 57.
Drevets WC, Price JL, Simpson JR Jr ve ark (1997) Subgenual Prefrontal Cortex Abnormalities in Mood Disorders. Nature; 386: 824-7.
Drevets WC, Price JL, Videen TO ve ark (1995) Metabolic Abnormalities in the Subgenual Prefrontal Cortex and Ventral Striatum in Mood Disorders. Neorusci Abstr 21: 260.
George MS, Ketter TA, Post RM (1993) Spect and Pet Imaging in Mood Disorders. J Clin Psychiatry 54 (suppl): 6-13.
George MS, Ring HA, Costa DC ve ark (1991) Neuroactivation and Neuroimaging with Spect, Springer-Verlag London Limited. Great Brain.
Gyulai L, Alavi A, Broich K ve ark (1997) I-123 Iofetamine Single Photon Emission Tomography in Rapid Cycling Bipolar Disorder: A Clinical Study. Biol Psychiatry; 41:152-161.
Goodwin GM (1996) Functional Imaging, Affective Disorder and Dementia. British Medical Bulletin; 52: 495-512.
Goodwin GM, Cavanagh JTO, Glabus MF ve ark (1997) Uptake of 99m Tc- 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.
Migliorelli R, Starkstein SE, Teson A ve ark (1993) SPECT Findings in Patients with Primary Mania. J Neuropsychiatry Clin Neurosci; 5: 379-383.
Mimura M, Nakagome K, Hirashima N ve ark (2005) Left Frontotemporal Hyperperfusion in A Patient with Post-Stroke Mania. Psychiatry Res Neuroimaging; 139: 263-267.
O’Connell RA, van Heertum RL, Luck D ve ark (1995) Single Photon Emission Computed Tomography of the Brain an Acute Mania and Schizophrenia. J Neuroimaging; 5: 101-104.
Rubin E, Sackeim HA, Prohovnik I ve ark (1995) Regional Cerebral Blood Flow in Mood Disorders: IV. Comparison of Mania and Depression. Psychiatry Res; 61: 1-10.
Soares JC, Mann JJ (1997) The Functional Neuroanatomy of Mood Disorders. J Psychiatr Res 31: 393-432.
Strakowski SM, DelBello MP, Adler CM (2005) The Functional Neuroanatomy of Bipolar Disorder: A Review of Neuroimaging Findings. Molecular Psychiatry; 10: 105-116.
Stoll AL, Renshaw PF, Yurgelin-Todd DA ve ark (2000) Neuroimaging in Bipolar Disorder: what Have we Learned? Biol Psychiatry; 48: 505-517.