RESULTS

Table 1 presents mean variables and standard deviations gathered in each one of the Brodmann areas that were analyzed in 23 basal studies and compared with 27 studies, gathered during frontal stimulation by means of Wisconsin Test. In the basal studies, we highlight the following observations:

1. - Significant hypoperfusion in orbito-frontal area corresponding to areas 11 and 12 of Brodmann, there is also hypoperfusion in area 38 of Brodmann that corresponds to the anterior segment of both temporal lobes (Figure 2). During the activation by means of Wisconsin Test, there is a significant increase of the area hypoperfused in the orbito-frontal area 12 (Table 1, figures 3 and 4). Furthermore, there is also enlargement of the area of hypoperfusion in area 38 in the right hemisphere, in both anterior Cyngulate gyri, area 24 of Brodmann and lastly in the Subgenual region of the anterior Cyngulate, left area 25, all with statistical significance (Figure 4).

Figure 1. (click=zoom)
NeuroSPECT, Normal young woman. Anterior, right lateral and right para saggital images in upper raw. Posterior, left lateral and left parasaggital images in lower raw. Brain cortical uptake of Tc99m HMPAO in colors red and green denoting values displayed between + 2SD and – 2SD from the Normal Mean, respectively. There are small multifocal areas of significant hypoperfusion distributed in a disorganized way. Color BLUE < 2SD below the Normal Mean, 95% probability of being true hypoperfusion.

Figure 2. (click=zoom)
Basal DEPRESSION NeuroSPECT. There is significant hypoperfusion, at more than 2SD below the Normal Mean, color Dark Blue involving the following Brodmann Areas: 11 and 12, Orbitofrontal Area, Area 38 and 25, Subgenual area. Of anterior Cyngulate Gyrus. The anterior Cyngulate Gyrus itself appears normal. Furthermore there is mild bilateral frontal hypoperfusion of other behavioral areas.

Figure 3. (click=zoom)
DEPRESSION. NeuroSPECT during frontal activation by Wisconsin Card Sorting Test. There is extensive hypoperfusion of both orbito-frontal lobes, areas 11 and 12. There is also hypoperfusion (color blue) in both Subgenual areas (25 of Brodmann) and Cyngulate Gyri, Area 24 of Brodmann and of both areas 38. Of note, there is paradoxically lack of stimulation of anterior frontal area, area M.

Figure 4. (click=zoom)
Statistical Analysis of basal vs. activation NeuroSPECT in DEPRESSION. During Activation there is increased hypoperfusion in the following areas at a p <. 009: Both Anterior Cyngulate Gyri and area 12 in Left hemisphere. With a P < .05 Wisconsin Spect appears more hypoperfused in Right area 38,Right area 11 and left area 25. Furthermore, the basal studies demonstrate extensive involvement with hypoperfusion of areas left 38 and left orbito-frontal.