PMID- 16373773
OWN - NLM
STAT- MEDLINE
DCOM- 20060127
LR  - 20131121
IS  - 0033-8419 (Print)
IS  - 0033-8419 (Linking)
VI  - 238
IP  - 1
DP  - 2006 Jan
TI  - Depressive psychosis: clinical usefulness of MR spectroscopy data in predicting 
      prognosis.
PG  - 248-55
AB  - PURPOSE: To prospectively assess the usefulness of magnetic resonance (MR) 
      spectroscopy data acquired before the initiation of medical therapy in predicting 
      prognosis in patients with depressive psychosis. MATERIALS AND METHODS: All 
      subjects gave written informed consent to an institutional committee for clinical 
      research-approved study protocol. The clinical course after medication in 52 
      patients with depressive psychosis (age range, 52-78 years; 21 men, 31 women) was 
      investigated. In all patients, MR spectroscopy was performed with a 1.5-T MR 
      imaging unit before the initiation of medical therapy. Cerebrovascular lesions 
      (CVLs), which appear as high-signal-intensity areas on T2-weighted MR images, 
      were evaluated by using the Fazekas rating scale. Patients were classified into 
      two groups on the basis of the ratio of N-acetylaspartate (NAA) to creatine and 
      phosphocreatine (Cr): Patients in group A had an NAA/Cr ratio greater than 1.91, 
      and patients in group B had an NAA/Cr ratio of 1.91 or less. To assess the 
      response of the patients to medication, standard psychiatric tests--the Verbal 
      Associative Fluency Test (VAFT), the Digit Symbol Test (DST), the Mini-Mental 
      State Examination (MMSE), and the Hamilton Depression Rating Scale (HAM-D)--were 
      administered before and after medical therapy was initiated. Mean test scores 
      before and after medication were compared with paired t testing. P < .05 was 
      considered to indicate a significant difference. RESULTS: There were 25 patients 
      in group A and 27 in group B. In group A, the mean VAFT and DST scores increased 
      and the mean HAM-D score decreased after medication. There was no significant 
      difference in mean MMSE scores before and after medication (P = .945 for group A 
      and P = .934 for group B). In group B, there were no significant differences in 
      any of the psychiatric test scores before and after medication. The 
      high-signal-intensity area score in group B was significantly higher than that in 
      group A (P = .004). CONCLUSION: MR spectroscopy data obtained before the 
      initiation of medical therapy were useful in predicting prognosis in patients 
      with depressive psychosis; this suggests that the combined burden of all CVLs may 
      affect the response to antidepressant medication.
CI  - RSNA, 2006.
FAU - Kado, Hirotsugu
AU  - Kado H
AD  - Department of Radiology, Akita Research Institute for Brain and Blood Vessels, 
      6-10 Kubotamachi, Sensyu, Akita 010-0874, Japan.
FAU - Kimura, Hirohiko
AU  - Kimura H
FAU - Murata, Tetsuhito
AU  - Murata T
FAU - Nagata, Ken
AU  - Nagata K
FAU - Kanno, Iwao
AU  - Kanno I
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Radiology
JT  - Radiology
JID - 0401260
RN  - 0 (Antidepressive Agents)
RN  - 30KYC7MIAI (Aspartic Acid)
RN  - 997-55-7 (N-acetylaspartate)
RN  - MU72812GK0 (Creatine)
RN  - N91BDP6H0X (Choline)
SB  - IM
MH  - Aged
MH  - Analysis of Variance
MH  - Antidepressive Agents/therapeutic use
MH  - Area Under Curve
MH  - Aspartic Acid/analogs & derivatives/metabolism
MH  - Choline/metabolism
MH  - Creatine/metabolism
MH  - Depressive Disorder/drug therapy/*metabolism
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Spectroscopy/*methods
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Psychiatric Status Rating Scales
EDAT- 2005/12/24 09:00
MHDA- 2006/01/28 09:00
CRDT- 2005/12/24 09:00
PHST- 2005/12/24 09:00 [pubmed]
PHST- 2006/01/28 09:00 [medline]
PHST- 2005/12/24 09:00 [entrez]
AID - 238/1/248 [pii]
AID - 10.1148/radiol.2381041375 [doi]
PST - ppublish
SO  - Radiology. 2006 Jan;238(1):248-55. doi: 10.1148/radiol.2381041375.