SPECT and neuropsychological performance in severe depression treated withECT

Background: In severe depression, studies of regional cerebral blood flow ( rCBF) by SPECT have not produced uniform results. The association between c hanges in SPECT and electroconvulsive therapy (ECT) has shown somewhat conf licting data. No data are available on benzodiazepine receptor function SPE CT studies in ECT. Methods: Twenty drug-resistant adult inpatients fulfilli ng the DSM-IIIR criteria for major depression were studied by SPECT (rCBF b y relative ECD uptake in all, and benzodiazepine receptor function by iomaz enil uptake in five subjects) before and I week after clinically successful bitemporal ECT. Clinical and neuropsychological test scores were used as r eferences for the possible changes in SPECT. Results: An increased perfusio n after ECT was observed in right temporal and bilateral parietal cortices, whereas no reductions in relative ECD uptake were seen after ECT. Iomazeni l-SPECT revealed a highly significant increase in the benzodiazepine recept or uptake in all studied cortical regions except temporal cortices. Conclus ions: Clinically successful ECT was associated with changes in vascular per fusion and GABAergic neurotransmission, providing new evidence for the mech anism of action of ECT and for the neurobiology of severe drug-resistant de pression. (C) 2001 Elsevier Science BY All rights reserved.