Prefrontal cortex dysfunction and depression in atypical parkinsonian syndromes. |
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Authors: | Birgit Herting MD Bettina Beuthien‐Baumann MD Katrin Pöttrich PhD Markus Donix MD Antje Triemer PhD Johannes B. Lampe MD Rüdiger von Kummer MD Karl Herholz MD Heinz Reichmann MD Vjera A. Holthoff MD |
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Affiliation: | 1. Department of Neurology, Technische Universit?t Dresden, GermanyDepartment of Neurology, Technische Universit?t Dresden, Fetscherstrasse 74, 01307 Dresden, Germany;2. Department of Nuclear Medicine, Technische Universit?t Dresden and PET‐Center, Research Center Rossendorf, Germany;3. Department of Psychiatry and Psychotherapy, Technische Universit?t Dresden, Germany;4. Department of Neurology, Technische Universit?t Dresden, Germany;5. Department of Neuroradiology, Technische Universit?t Dresden, Germany;6. Manchester Molecular Imaging Center, Manchester, England |
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Abstract: | Depressive symptoms are common in patients with neurodegenerative disorders. Imaging studies suggest that a disruption of frontal-subcortical pathways may underlie depression associated with basal ganglia disease. This pilot study tested the hypothesis that frontal dysfunction contributes to depression associated with multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). Depressed patients with MSA (n = 11), PSP (n = 9), and age-matched controls (n = 25) underwent measures of cerebral glucose metabolism applying positron emission tomography with (18)F-fluorodeoxyglucose. Regional metabolism in the patient groups was compared to the normal subjects using the voxel-based statistical parametric mapping. Depressive symptom severity (Hamilton Depression Rating) and degree of locomotor disability (Hoehn & Yahr) were assessed in the patient groups. The association between prefrontal metabolism and the occurrence of depressive symptoms and the degree of locomotor disability was investigated. When compared to controls, MSA patients revealed significant metabolic decreases in bilateral frontal, parietal, and cerebellar cortex and in the left putamen. In PSP patients, significant hypometabolism was demonstrated in bilateral frontal cortex, right thalamus, and midbrain. Depression severity but not the patients' functional condition was significantly associated with dorsolateral prefrontal glucose metabolism in both patient groups. The findings of this pilot study support the hypothesis that depressive symptoms in MSA and PSP are associated with prefrontal dysfunction. |
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Keywords: | multiple system atrophy progressive supranuclear palsy depression tomography emission‐computed frontal lobe |
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