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Prefrontal cortical hypometabolism during low-dose interferon alpha treatment
F D Juengling1, D Ebert, O Gut
1Department of Radiology, University of Freiburg, Germany.
Psychopharmacology
|January 5, 2001
Summary
Low-dose interferon alpha (IFN-alpha) treatment for hepatitis C caused significant prefrontal cortex hypometabolism. This brain metabolism change correlated with depression and may predispose patients to neuropsychiatric side effects.
Area of Science:
- Neuroscience
- Medical Imaging
- Psychiatry
Background:
- Interferon alpha (IFN-alpha) is used to treat chronic hepatitis C.
- IFN-alpha treatment can be associated with neuropsychiatric side effects.
- Cerebral glucose metabolism changes may underlie these side effects.
Purpose of the Study:
- To prospectively evaluate the effects of low-dose IFN-alpha on cerebral glucose metabolism.
- To correlate these metabolic changes with neuropsychiatric symptoms during treatment.
Main Methods:
- Eleven patients with chronic hepatitis C received low-dose IFN-alpha.
- Neuropsychiatric tests and [18F]deoxyglucose positron emission tomography (FDG-PET) were performed before and at 12 weeks of treatment.
- Statistical parametric mapping (SPM96) was used for PET image analysis, with covariance analysis for correlations.
Main Results:
- Significant bilateral prefrontal cortex hypometabolism (8-12% decrease) was observed in all patients by week 12.
- This hypometabolism correlated with increased depression scores (Beck's Depression Inventory).
- Hypermetabolism was noted in the putamina and left occipital region; depressive symptoms increased from 1/11 to 6/11 patients.
Conclusions:
- Low-dose IFN-alpha therapy is linked to significant prefrontal hypometabolism.
- This metabolic change is associated with depression, even in non-depressed patients.
- Prefrontal hypometabolism may be a predisposing factor for IFN-alpha-induced neuropsychiatric syndromes.