SPECT imaging in psychiatry: introduction and overview.

Clinical Brain Disorders Branch, National Institute of Mental Health, St. Elizabeth's, Washington, DC 20032.
The Journal of Clinical Psychiatry (Impact Factor: 5.14). 12/1993; 54 Suppl:3-5.
Source: PubMed

ABSTRACT Positron emission tomography (PET) and single photon emission computed tomography (SPECT) use advanced computer image construction techniques to illustrate regional cerebral function, metabolism, and chemistry. Although the resolution of PET is higher than that of SPECT, and the technical development of SPECT has lagged behind that of PET, SPECT has recently enjoyed increasingly widespread use, particularly because its costs and technology are within the reach of all clinical nuclear medicine facilities. SPECT imaging agents have greater half-lives than those used with PET, thereby permitting longer and more detailed neurochemistry study than is possible with PET. The research value of both methods has unique potential compared with computed tomography (CT) and magnetic resonance imaging (MRI), which traditionally have provided a static image of the brain's structure or anatomy.

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    ABSTRACT: Data on functional imaging of bipolar disorder (BD) utilizing single photon emission computerized tomography (SPECT) is limited. This study assessed regional cerebral blood flow (rCBF), using (99m)Tc-ECD SPECT, among patients with BD, with mania (N=10) or depression (N=10), compared with 10 patients with unipolar depression and 10 normal controls. Regions of interest were analysed using a semi-automatic brain quantification programme. Compared to controls, patients with mania had significantly reduced perfusion mainly in the left frontal area, also in the left anterior cingulate and parietal cortices; those with bipolar depression had significantly lowered rCBF principally in the anterior temporal regions bilaterally, as well as the left parietal area. Patients with unipolar depression had significantly lowered perfusion than controls in most of the regions examined, chiefly in the anterior temporal and frontal cortices bilaterally; they also had lowered perfusion in the right anterior temporal and frontal areas, as well as the right middle temporal area and the right thalamus, compared to patients with mania. Increased severity of psychotic symptoms was associated with reduced rCBF in patients. These results indicate that altered blood flow in the frontal-subcortical systems characterises patients with BD, as well as those with unipolar depression.
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