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Am J Psychiatry 1992; 149:538-543
Copyright © 1992 by American Psychiatric Association
Effect of sleep deprivation on brain metabolism of depressed patients
JC Wu, JC Gillin, MS Buchsbaum, T Hershey, JC Johnson and WE Bunney Jr
Department of Psychiatry and Human Behavior, College of Medicine, University of California, Irvine 92717.
OBJECTIVE: Sleep deprivation is a rapid, nonpharmacologic antidepressant
intervention that is effective for a subset of depressed patients. The
objective of this study was to identify which brain structures' activity
differentiates responders from nonresponders and to study how metabolism in
these brain regions changes with mood. METHOD: Regional cerebral glucose
metabolism was assessed by positron emission tomography (PET) with
[18F]deoxyglucose (FDG) before and after total sleep deprivation in 15
unmedicated awake patients with unipolar major depression and 15 normal
control subjects, who did the continuous performance test during FDG
uptake. RESULTS: After sleep deprivation, four patients showed a 40% or
more improvement on the Hamilton Rating Scale for Depression. Before sleep
deprivation the depressed responders had a significantly higher cingulate
cortex metabolic rate than the depressed nonresponders, and this normalized
after sleep deprivation. The normal control subjects and nonresponding
depressed patients showed no change in cingulate metabolic rate after sleep
deprivation. CONCLUSIONS: Overactivation of the limbic system as assessed
by PET scans may characterize a subset of depressed patients. Normalization
of activity with sleep deprivation is associated with a decrease in
depression.
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