Changes in cerebral blood flow associated with premenstrual syndrome: a preliminary study

The purpose of this study was to determine changes in regional cerebral blo od flow (rCBF) associated with premenstrual syndrome (PMS). Regional CBF wa s examined using single photon emission computed tomography (SPECT) in seve n women who sought treatment for PMS and seven control subjects. Confirmati on of PMS was based on the Daily Symptom Report (DSR) of 17 common symptoms associated with PMS. A first SPECT scan was performed near the peak of pre menstrual symptoms based on DSR reports from the two previous cycles. A sec ond scan was performed in the postmenstrual period. Prior to scanning, each subject had a Hamilton Depression Rating Scale (Ham-D) obtained, Regions o f interest were drawn on the images to generate mean counts per pixel, and normalized to the cerebellum. Activity in the frontal, temporal and parieto -occipital cortices, and the thalami and basal ganglia, were compared betwe en the two scans. Correlations between activity in each region of interest and Ham-D values were also determined. There were marked decreases in rCBF in the temporal lobes on the premenstrual scan compared to the postmenstrua l scan in PMS patients. Significant correlations were observed between the change in rCBF in the right and left temporal lobes and the changes in Ham- D scores (r = 0.91, p < 0.01 and r = 0.86, p = 0.01 respectively). No rCBF changes were observed in controls. We conclude that SPECT imaging demonstra tes modest decreases in rCBF in the temporal lobes that correlate with the level of depression in subjects with PMS.