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Nuklearmedizin 2014; 53(05): 205-210
DOI: 10.3413/Nukmed-0632-13-11
Original article
Schattauer GmbH

The role of cognitive group therapy and happiness training on cerebral blood flow using 99mTc-ECD brain perfusion SPECT

A quasi-experimental study of depressed patientsDie Wirkung der kognitiven Gruppentherapie und des Glückstrainings auf die zerebrale Durchblutung mittels 99mTc-ECD Hirndurchblutungs-SPECTEine quasi-experimentelle Studie an depressiven Patienten
M. Azizi
1   Department of Psychology, Sarab Branch, Islamic Azad University, Sarab, Iran
,
S. A. Bahrieniain
2   Department of Psychology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
A. Baghdasarians
3   Islamic Azad University Central Tehran, Iran
,
S. Emamipur
3   Islamic Azad University Central Tehran, Iran
,
Z. Azizmohammadi
4   Department of Nuclear Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
S. M. Qutbi
4   Department of Nuclear Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
,
H. Javadi
5   Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran
,
M. Assadi
6   The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
,
I. N. Asli
4   Department of Nuclear Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
› Author Affiliations
Further Information

Publication History

received: 08 November 2013

accepted in revised form: 16 April 2014

Publication Date:
02 January 2018 (online)

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Summary

Objective: The purpose of this study is to investigate the impact of cognitive group therapy and happiness training objectively in the local cerebral blood flow of patients with major depression (MD). Patients, material, methods: The present research is semi-experimental to pre- and post-test with a control group. Three groups were formed, and this number was incorporated in each group: 12 patients were chosen randomly; the first group of depressed patients benefited from the combination of pharmacotherapy and sessions of cognitive group therapy; the second group used a combination of pharmaco- therapy and sessions of happiness training; and a third group used only pharmacother- apy. We compared cognitive-behavioural therapy and happiness training efficacy with only pharmacotherapy in MD patients. We performed brain perfusion SPECT in each group, before and after each trial. Results: The study was conducted on 36 patients with MD (32 women and 4 men; mean age: 41.22 ± 9.08; range: 27-65 years). There were significant differences regarding the two trial effects into two experimental groups (p < 0/001) before and after trials, while such differences were not significant in the control group (p > 0.05). In addition, there was significant difference among the regional cerebral blood flow in the frontal and prefrontal regions into two experimental groups before and after trials (p < 0/001), while such differences were not significant in the control group (p > 0.05). Conclusion: This study demonstrated decreased cerebral perfusion in the frontal regions in MD patients, which increased following cognitive group therapy and happiness training. Because of its availability, low costs, easy performance, and the objective semi-quantitative information supplied, brain perfusion SPECT

Zusammenfassung

In dieser Studie sollen die objektiven Auswirkungen untersucht werden, die kognitive Gruppentherapie und Glückstraining bei Patienten mit Major Depression (MD) auf die lokale Hirndurchblutung haben. Patienten, Material, Methoden: Diese Untersuchung hat ein semi-experimentelles Prätest-PosttestDesign mit einer Kontrollgruppe. Drei Gruppen mit gleicher Patientenzahl wurden gebildet: 12 Patienten wurden zufällig ausgewählt. Die erste Gruppe depressiver Patienten profitierte von der Kombination aus Phar- makotherapie und kognitiver Verhaltenstherapie. In der zweiten Gruppe wurde die Phar- makotherapie mit Glückstraining kombiniert. Die dritte Gruppe erhielt nur Pharmakotherapie. Wir verglichen die Wirksamkeit der kognitiven Verhaltenstherapie und des Glückstrainings mit der medikamentösen Monotherapie bei Patienten mit MD. In jeder Gruppe führten wir vor und nach der Studie ein Hirn- durchblutungs-SPECT durch. Ergebnisse: Die Studie wurde an 36 Patienten mit MD durchgeführt (32 Frauen und 4 Männer; mittleres Alter: 41,22 ± 9,08 Jahre; Spanne: 27-65 Jahre). In den beiden experimentellen Gruppen unterschieden sich die beiden Wirksamkeitsparameter vor und nach der Studie signifikant (p < 0,001), während diese Unterschiede in der Kontrollgruppe nicht signifikant waren (p > 0,05). Außerdem gab es in den beiden experimentellen Gruppen vor und nach der Studie signifikante Unterschiede bei der regionalen Hirndurchblutung in frontalen und präfrontalen Bereichen (p < 0,001), in der Kontrollgruppe waren auch diese Unterschiede nicht signifikant (p > 0,05). Schlussfolgerung: Die Studie zeigt bei Patienten mit MD in den frontalen Bereichen eine verminderte zerebrale Durchblutung, die nach einer kognitiven Verhaltenstherapie und einem Glücktraining ansteigt. Aufgrund ihrer Verfügbarkeit, den niedrigen Kosten, der leichten Durchführbarkeit und der sich ergebenden objektiven semi-quantitativen Informationen könnte die Untersuchung mittels Hirndurch- blutungs-SPECT hilfreich bei der Diagnostik und der Therapiekontrolle sein. Weitere Untersuchungen sind notwendig, um die klinische Bedeutung zu validieren.

Keywords

Major depression - cognitive group therapy - happiness training - brain perfusion SPECT

Schlüsselwörter

Major Depression - kognitive Gruppentherapie - Glückstraining - Hirndurchblutungs SPECT
 

  • References

  • 1 Cunningham MG, Goldstein M, Katz D. et al. Coalescence of psychiatry, neurology, and neuropsychology: from theory to practice. Harvard review of psychiatry 2006; 14: 127-140.
    CrossrefPubMedGoogle Scholar
  • 2 Goethals I, Audenaert K, Jacobs F. et al. Toward clinical application of neuropsychological activation probes with SPECT: a spatial working memory task. J Nucl Med 2002; 43: 1426-1431.
    PubMedGoogle Scholar
  • 3 Gazzaniga MS. The New Cognitive Neurosciences:. The MIT Press; 2001: 1276
  • 4 Kohn Y, Freedman N, Lester H. et al. 99mTc-HMPAO SPECT study of cerebral perfusion after treatment with medication and electroconvulsive therapy in major depression. J Nucl Med 2007; 48: 1273-1278.
    CrossrefPubMedGoogle Scholar
  • 5 George MS, Ketter TA, Post RM. SPECT and PET imaging in mood disorders. The Journal of clinical psychiatry 1993; 54 (Suppl) 6-13.
    PubMedGoogle Scholar
  • 6 Navarro V, Gasto C, Lomena F. et al. Normalization of frontal cerebral perfusion in remitted elderly major depression: a 12-month follow-up SPECT study. NeuroImage 2002; 16: 781-787.
    CrossrefPubMedGoogle Scholar
  • 7 Sackeim HA, Prohovnik I, Moeller JR. et al. Regional cerebral blood flow in mood disorders. I. Comparison of major depressives and normal controls at rest. Archives of general psychiatry 1990; 47: 60-70.
    CrossrefPubMedGoogle Scholar
  • 8 Baxter Jr LR, Phelps ME, Mazziotta JC. et al. Cerebral metabolic rates for glucose in mood disNuklearmedizin 5/2014 orders. Studies with positron emission tomography and fluorodeoxyglucose F 18. Archives of general psychiatry. 1985; 42: 441-447.
    CrossrefPubMedGoogle Scholar
  • 9 Cohen RM, Gross M, Nordahl TE. et al. Preliminary data on the metabolic brain pattern of patients with winter seasonal affective disorder. Archives of general psychiatry 1992; 49: 545-552.
    CrossrefPubMedGoogle Scholar
  • 10 Ishizaki J, Yamamoto H, Takahashi T. et al. Changes in regional cerebral blood flow following antidepressant treatment in late-life depression. International journal of geriatric psychiatry 2008; 23: 805-811.
    CrossrefPubMedGoogle Scholar
  • 11 Willeumier K, Taylor DV, Amen DG. Decreased cerebral blood flow in the limbic and prefrontal cortex using SPECT imaging in a cohort of completed suicides. Translational psychiatry 2011; 1: e28.
    CrossrefPubMedGoogle Scholar
  • 12 Hosokawa T, Momose T, Kasai K. Brain glucose metabolism difference between bipolar and unipolar mood disorders in depressed and euthymic states. Progress in neuro-psychopharmacology & biological psychiatry 2009; 33: 243-250.
    CrossrefPubMedGoogle Scholar
  • 13 Nagafusa Y, Okamoto N, Sakamoto K. et al. Assessment of cerebral blood flow findings using 99mTc-ECD single-photon emission computed tomography in patients diagnosed with major depressive disorder. Journal of affective disorders 2012; 140: 296-299.
    CrossrefPubMedGoogle Scholar
  • 14 Savitz J, Drevets WC. Bipolar and major depressive disorder: neuroimaging the developmental-degenerative divide. Neuroscience and biobehavioral reviews 2009; 33: 699-771.
    CrossrefPubMedGoogle Scholar
  • 15 Kimura M, Shimoda K, Mizumura S. et al. Regional cerebral blood flow in vascular depression assessed by 123I-IMP SPECT. Journal of Nippon Medical School 2003; 70: 321-326.
    CrossrefPubMedGoogle Scholar
  • 16 Smith DJ, Cavanagh JT. The use of single photon emission computed tomography in depressive disorders. Nuclear medicine communications 2005; 26: 197-203.
    CrossrefPubMedGoogle Scholar
  • 17 Mayberg HS, Liotti M, Brannan SK. et al. Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness. The American journal of psychiatry 1999; 156: 675-682.
    PubMedGoogle Scholar
  • 18 Graff-Guerrero A, Gonzalez-Olvera J, Mendoza-Espinosa Y. et al. Correlation between cerebral blood flow and items of the Hamilton Rating Scale for Depression in antidepressant-naive patients. Journal of affective disorders 2004; 80: 55-63.
    CrossrefPubMedGoogle Scholar
  • 19 Vlassenko A, Sheline YI, Fischer K, Mintun MA. Cerebral perfusion response to successful treatment of depression with different serotoninergic agents. The Journal of neuropsychiatry and clinical neurosciences 2004; 16: 360-363.
    CrossrefPubMedGoogle Scholar
  • 20 Fitzgerald PB, Laird AR, Maller J, Daskalakis ZJ. A meta-analytic study of changes in brain activation in depression. Human brain mapping 2008; 29: 683-695.
    CrossrefPubMedGoogle Scholar
  • 21 Schwarzbold M, Diaz A, Tostes Martins E. et al. Psychiatric disorders and traumatic brain injury. Neuropsychiatr Dis Treat 2008; 4: 797-816.
    PubMedGoogle Scholar
  • 22 Brown GP, Hammen CL, Craske MG, Wickens TD. Dimensions of dysfunctional attitudes as vulnerabilities to depressive symptoms. Journal of abnormal psychology 1995; 104: 431-435.
    CrossrefPubMedGoogle Scholar
  • 23 McGreal R, Joseph S. The Depression-Happiness Scale. Psychological reports 1993; 73: 1279-1282.
    CrossrefPubMedGoogle Scholar
  • 24 Samadzadeh M, Shahbazzadegan B, Abbasi M. Study of Fordayce Happiness Model Effectiveness on quality of life in patients undergo dialysis and patients who suffering from cancer procedia. Social and Behavioral Sciences 2013; 83: 644-649.
    Google Scholar
  • 25 Bench CJ, Frackowiak RS, Dolan RJ. Changes in regional cerebral blood flow on recovery from depression. Psychological medicine 1995; 25: 247-261.
    CrossrefPubMedGoogle Scholar
  • 26 Galynker II, Cai J, Ongseng F, Finestone H, Dutta E, Serseni D. Hypofrontality and negative symptoms in major depressive disorder. J Nucl Med 1998; 39: 608-612.
    PubMedGoogle Scholar
  • 27 Philpot MP, Banerjee S, Needham-Bennett H. et al. ““Tc-HMPAO single photon emission tomography in late life depression: a pilot study of regional cerebral blood flow at rest and during a verbal fluency task. Journal of affective disorders 1993; 28: 233-240.
    CrossrefPubMedGoogle Scholar
  • 28 Yao WJ, Pan HA, Wang ST. et al. Frontal cerebral blood flow changes after hormone replacement therapy in depressed postmenopausal women. Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism 2009; 29: 1885-1890.
    CrossrefPubMedGoogle Scholar
  • 29 Kocmur M, Milcinski M, Budihna NV. Evaluation of brain perfusion with technetium-99m bicisate single-photon emission tomography in patients with depressive disorder before and after drug treatment. Eur J Nucl Med 1998; 25: 1412-1414.
    CrossrefPubMedGoogle Scholar
  • 30 Yazici KM, Kapucu O, Erbas B. et al. Assessment of changes in regional cerebral blood flow in patients with major depression using the WmTc-HMPAO single photon emission tomography method. Eur J Nucl Med 1992; 19: 1038-1043.
    PubMedGoogle Scholar
  • 31 Perico CA, Skaf CR, Yamada A. et al. Relationship between regional cerebral blood flow and separate symptom clusters of major depression: a single photon emission computed tomography study using statistical parametric mapping. Neuroscience letters 2005; 384: 265-270.
    CrossrefPubMedGoogle Scholar
  • 32 Kim SJ, Song SH, Kim JH, Kwak IS. Statistical parametric mapping analysis of the relationship between regional cerebral blood flow and symptom clusters of the depressive mood in patients with pre-dialytic chronic kidney disease. Ann Nucl Med 2008; 22: 201-206.
    CrossrefPubMedGoogle Scholar
  • 33 Grimm S, Beck J, Schuepbach D. et al. Imbalance between left and right dorsolateral prefrontal cortex in major depression is linked to negative emotional judgment: an fMRI study in severe major depressive disorder. Biological psychiatry 2008; 63: 369-376.
    CrossrefPubMedGoogle Scholar
  • 34 Townsend J, Bookheimer SY, Foland-Ross LC. et al. fMRI abnormalities in dorsolateral prefrontal cortex during a working memory task in manic, euthymic and depressed bipolar subjects. Psychiatry research 2010; 182: 22-29.
    CrossrefPubMedGoogle Scholar
  • 35 Brockmann H, Zobel A, Joe A. et al. The value of HMPAO SPECT in predicting treatment response to citalopram in patients with major depression. Psychiatry research 2009; 173: 107-112.
    CrossrefPubMedGoogle Scholar
  • 36 Brody AL, Saxena S, Stoessel P. et al. Regional brain metabolic changes in patients with major depression treated with either paroxetine or interpersonal therapy: preliminary findings. Archives of general psychiatry 2001; 58: 631-640.
    CrossrefPubMedGoogle Scholar