FUNCTIONAL NEUROIMAGING STUDIES OF DEPRESSION: The Anatomy of Melancholia

• Published in: Annual review of medicine Vol. 49; no. 1; pp. 341 - 361
• Main Author: Drevets, MD, Wayne C
• Format: Journal Article
• Language: English
• Published: Palo Alto, CA 94303-0139 Annual Reviews 01.01.1998; 4139 El Camino Way, P.O. Box 10139 Annual Reviews, Inc; USA
• Subjects: Adult and adolescent clinical studies; Affect - physiology; Antidepressants; Anxiety; Biological and medical sciences; Brain - metabolism; Brain - pathology; Brain - physiopathology; Brain research; cerebral blood flow; Cerebral Cortex - metabolism; Cerebral Cortex - pathology; Cerebral Cortex - physiopathology; cerebral glucose metabolism; Cerebrovascular Circulation - physiology; Depression; Depressive Disorder - metabolism; Depressive Disorder - pathology; Depressive Disorder - physiopathology; Depressive Disorder - therapy; Diagnostic Imaging; Emotions - physiology; Glucose; Glucose - metabolism; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; major depression; Medical imaging; Medical sciences; Mental depression; Metabolism; Mood disorders; Mood Disorders - metabolism; Mood Disorders - pathology; Mood Disorders - physiopathology; Mood Disorders - therapy; MRI (magnetic resonance imaging); Neuroimaging; Neurons - physiology; Neurophysiology; Pathophysiology; Patient Selection; PET (positron emission tomography); Physiology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotropic drugs; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon; Mood disorder; Human; Melancholia; Pathophysiology; Radiodiagnosis; Functional test; Depression; Anatomy; Blood flow; Medical imagery; Hemodynamics; Bibliographic review; Brain (vertebrata)
• ISSN: 0066-4219; 1545-326X
• DOI: 10.1146/annurev.med.49.1.341

Functional brain imaging techniques, which permit noninvasive measures of neurophysiology and neuroreceptor binding, are powerful and sensitive tools for research aimed at elucidating the pathophysiology of major depression. The application of these technologies in depression research has produced several studies of resting cerebral blood flow (BF) and glucose metabolism in subjects imaged during various phases of illness and treatment. This review examines these data and the principles relevant to their interpretation and discusses the insights they provide into the anatomical correlates of depression. Within the anatomical networks implicated in emotional processing by other types of evidence, these BF and metabolic data demonstrate that major depression is associated with reversible, mood state-dependent, neurophysiological abnormalities in some structures and irreversible, trait-like abnormalities in other structures. In some of the regions in which trait-like abnormalities appear, abnormal metabolic activity appears at least partly related to the anatomical abnormalities identified in magnetic resonance imaging (MRI) studies of depression.