PS178. The Normalization of Brain 18 F-FDG Hypometabolism following Electroconvulsive therapy in a 55-Year-Old Woman with Treatment-Resistant Late onset Depression: Case report

Abstract

Major depressive disorder, especially in later life, has heterogeneous clinical characteristics and treatment responses. For symptomatology, psychomotor retardation, lack of energy, and apathy tended to be more common in people with late-onset depression(LOD). In spite of recent advances in psychopharmacologic treatments, 20–30% of patients with mood disorders experience inadequate responses to medication, often resulting in a trial of electroconvulsive therapy (ECT). However the therapeutic mechanism of ECT is steal remain unknown. By using 18F-fluorodeoxy-D-glucose positron emission tomography-computed tomography (18F-FDG PET/CT), we can obtain the status of brain metabolism which of patients with neuropsychiatric disorders and its changing during psychiatric treatment course.

In this case report, we introduce 55-year-old female patient who suffered psychotic depression which was treatment-resistant during pharmacological approach. Several antidepressants and atypical antipsychotics were applied but there was no improvement in her symptoms. The patient represent not only depressed mood and behaviors but also deficit in cognitive functions. We could find decreased diffuse cerebral metabolism in her brain FDG PET/CT image. By underwent ECT, symptoms of the patient cleared and another brain PET imaging which was taken 7 weeks later from the last ECT course the metabolism of her brain was normalized.