@article{oai:repo.qst.go.jp:00044856,
 author = {Kado, Hirotsugu and Kimura, Hirohiko and Murata, Tetsuhito and Nagata, Ken and Kanno, Iwao and 菅野 巖},
 issue = {1},
 journal = {Radiology},
 month = {Jan},
 note = {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.},
 pages = {248--255},
 title = {Depressive psychosis: clinical usefulness of MR spectroscopy data in predicting prognosis},
 volume = {238},
 year = {2006}
}