Psychotic symptoms in major depressive disorder are associated with reduced regional cerebral blood flow in the subgenual anterior cingulate cortex: a voxel-based single photon emission computed tomography (SPECT) study

Background: Delusions and/or hallucinations are not an uncommon feature in severe major depressive episodes. Functional imaging studies of depression have been widely reported in the literature, but few of these have attempted to investigate the neurophysiological correlates of psychotic symptoms. Methods: We measured resting regional cerebral blood flow (rCBF) with the 99mTc-ECD SPECT technique in patients with major depressive disorder with ( n=9) and without ( n=12) psychotic features, as well as in a group of healthy volunteers ( n=12). Between-group rCBF comparisons were performed using the voxel-based statistical parametric mapping method. Results: Major depressed patients with psychotic features showed decreased rCBF in the left subgenual anterior cingulate cortex relative to both non-psychotic patients and healthy controls ( P