Depressive Disorders: Focally Altered Cerebral Perfusion Measured with Arterial Spin-labeling MR Imaging

Purpose: To assess focal cerebral perfusion in patients with refractory depressive disorder (RDD), patients with nonrefractory depressive disorder (NDD), and healthy control subjects by using arterial spin-labeling (ASL) magnetic resonance (MR) imaging. Materials and Methods: This study was approved by the local ethical committee, and written informed consent was obtained from all participants. Twenty-four patients with RDD, 37 patients with NDD, and 42 healthy control subjects were included. From February 2006 to July 2007, all participants were imaged with a 3-T MR system. ASL and echo-planar images were subtracted and averaged to give perfusion-weighted images. Voxel-based analysis was performed. Region-of-interest analysis was applied to the bilateral hippocampi, thalami, and lentiform nuclei. Results: Patients with NDD showed reduced perfusion in the left prefrontal cortex versus control subjects and increased perfusion mainly in the limbic-striatal areas (P < .05). In contrast, patients with RDD had...