Cortical Brain Perfusion and Cognitive Event Related Potentials in Patients with Psychomotor Retardation in Late Onset Depression.

BACKGROUND: Late onset depression is characterised by pronounced cognitive impairment, more somatic complaints and psychomotor retardation. Psychomotor slowing may be due to impairment in either motor or cognitive domain. Electrophysiology may be particularly convenient as a tool in studies of psychomotor retardation, as it can separate central cognitive processing from the motor processing. SUBJECTS AND METHODS: In this study we compared event related potentials (ERP) in the two groups of patients with late onset depression and psychomotor slowing as measured by reaction time (RT): a group of patients with lower RT was compared to a group with a higher RT. Twenty patients with late onset depression were included in the study after they had reached remission. Four weeks after reaching remission patients were reevaluated clinically using Hamilton Depression Rating Scale, Mini Mental State Examination, and with a computer version of the Stroop task. ERP, accuracy and RTs were simultaneously recorded. Both groups of patients aditionaly underwent a perfusion SPECT imaging. RESULTS: There were no differences between the short and long RT groups of patients in amplitudes of the late positive Stroop related potentials. The group of patients with longer RTs showed significant hyperperfusion in precentral gyrus, parietal regions, cuneus and hypoperfusion within insular, frontal, temporal and limbic (parahyppocampal gyrus and anterior cingulate) cortices, as well as cerebellum. CONCLUSION: We found no ERP differences between the two groups suggesting that although patients may differ on psychomotor retardation measured as RT, their cognitive abilities may be quite similar. Perfusion SPECT imaging however revealed a significant difference between them. This may be due to a process of compensation and applying different strategies to cope with cognitive impairment in the two groups.