Regional cerebral blood flow in drug-naive patients with depression and mania using Tc-99m HMPAO single photon emission computerised tomography (SPECT)

Tc-99m hexamethylpropylene amine-oxime (HMPAO) SPECT was used to compare regional cerebral blood flow (rCBF) in actue drug-naive twenty-one depressed, thirteen manic and twenty-four schizophrenic patients. Of those, eleven depressed, ten manics and twenty schizophrenics also had computed tomography (CT) brain scaninng Only three patients, one depressed and two schizophrenics showed CT abnormalities. Four depressed, four manics and six schizophrenics demonstrated hypoperfusion, and one manic and one schizophrenic demonstrated hyperperfusion. One manic and one schizophrenic demonstrated bilateral multiple focal lesions of hypo- and hyper-perfusions. The results of this study showed rCBF in depressed and manic patients to be mainly either normal or hypoperfused, and did nor support the hypothesis of hypofrontality in drug-naive patients with depression and schizophrenia. However, some support was obtained for the left lateralised reduction in CBF in some acute affectively disordered and schizophrenic patients. The functional rCBF changes shown by SPECT in some patients in this study were not matched by structural deficits on CT brain scans.