Abstract
Background
Studies of mental disorders using single photon emission computed tomography (SPECT) have been done for many years in China. Many results have been obtained. We review these findings and introduce them to the outside world.
Methods
SPECT papers available on the Chinese Biomedical Bibliographic Database, focusing on depression, schizophrenia, Alzheimer’s disease (AD), vascular dementia (VD), anxiety disorder, and obsessive compulsive disorder (OCD) in China, were reviewed and the results were compared with those obtained outside China.
Results
We found that regional cerebral blood flow (rCBF) was abnormal in mental disorders, but the specificity of the abnormality is not yet consistent. Lower perfusion of rCBF could be seen in frontal, temporal, and parietal lobes of patients with depression, AD, schizophrenia, and VD. It seems that abnormality of the frontal lobe is more common in depression and schizophrenia, but temporal lobe abnormalities are more common in AD and VD. The perfusion of rCBF in the parietal lobe seems to be related to aging. Abnormalities in the occipital lobe and basal ganglia seem to be more associated with vascular problems. Thalamic dysfunction was mainly correlated with VD, and that of the cingulate largely with depression and schizophrenia. Hippocampal abnormalities were associated with AD. There were few reports on changes in anxiety disorders and other mental problems.
Conclusion
There is no specific biological marker of SPECT for individual mental disorders. Further study is needed to provide more specific information on the pathophysiology of mental disorders. It seems that brain abnormalities are similar in Chinese and non Chinese psychiatric patients.
Introduction
Functional brain imaging has assumed a leading role in neuropsychiatric research. However, findings reported for mental disorders often vary. Whether this reflects diversity in pathophysiology or heterogeneity of imaging techniques and data analysis procedures is still unknown. Single photon emission computed tomography (SPECT) is one of the techniques of functional imaging that can be used to detect regional cerebral blood flow (rCBF) in the brain of subjects in different states. rCBF is closely related to metabolism and physiology of the brain. The technique of SPECT was first used in psychiatry in the early 1990s (CitationAustin et al 1992), when it was found that depressed patients showed reduced uptake in most cortical and subcortical regions examined, most significantly in temporal, inferior frontal, and parietal areas. SPECT was first used in the study of depression in China in 1995 (CitationDeng et al 1995), then later in schizophrenia, Alzheimer’s disease, and other mental disorders. Since then, many studies have been made using SPECT in mental disorders in China. What are the results of SPECT studies in China? What are the differences between these results in China and those in other countries? Here we review SPECT studies in psychiatry in China.
Method
We collected all SPECT papers focused on depression, schizophrenia, Alzheimer’s disease, anxiety disorder, and obsessive compulsive disorder published in the Chinese language in China and available in the Chinese Biomedical Bibliographic Database from 1990 to 2004. All publications have been copyrighted and published openly in China. All patients and researchers are Chinese. All overlapping articles were excluded.
Results
We found a total of 31 articles fitting our defined criteria. Three were excluded due to overlap. Six papers were studies on depression (CitationDeng et al 1995, Citation1997; CitationZhao et al 1998, Citation2000; CitationJiang et al 2000; CitationAng et al 2003), 9 studied Alzheimer’s disease (AD) (CitationJia and Gao 1996; CitationLiu et al 1997; CitationAng, Jiang, et al 1998; CitationAng, Zhang, et al 1998; CitationAng et al 1999, 2000; CitationXu, Huang, et al 1999; CitationXu, Zheng, et al 1999; CitationPeng et al 2001), and 13 others studied schizophrenia (CitationHu et al 1996; CitationLi, Deng, et al 1996; CitationLi, Tang, et al 1996; CitationLi, Zhao, et al 1996; Li et al 1997; CitationYu et al 1998; CitationLi et al 2001; CitationZhou et al 2001; CitationLi, Jiang, 2002; CitationLi, Xiu, et al 2002; CitationLiu et al 2002; CitationWan et al 2002; CitationWang et al 2003). Only 1 study was found on anxiety disorder (CitationWan et al 2002), 1 on obsessive compulsive disorder (OCD) (CitationLi, Jiang, et al 2002), and 1 on heroin addicts (CitationWang et al 2003).
Depression
As shown in , there was only 1 retrospective study, which included just 5 patients (CitationDeng et al 1995). Patients with reactive depression showed low rCBF only in the right temporal lobe whereas subjects with endogenous depression displayed low rCBF both in the right temporal lobe and the right frontal-parietal lobe. Five other papers concerned prospective controlled studies with larger samples, from 11 to 39 subjects, using ICD-10, DSM-IV, CCMD-2, and CCMD-2-R criteria.
Table 1 A review of SPECT papers on depression in China
All 6 studies found lower rCBF in the frontal lobe of patients with depression than in controls: 1 was in the right frontal (CitationDeng et al 1995), 2 in the left frontal (CitationDeng et al 1997; CitationZhao et al 1998), and 3 were bilateral (CitationJiang et al 2000; CitationZhao et al 2000; CitationAng et al 2003). Four authors found lower rCBF in the temporal lobe also (CitationDeng et al 1995, Citation1997; CitationZhao et al 1998, Citation2000). Five studies found lower rCBF in the parietal lobe, mainly in the right (CitationDeng et al 1995, Citation1997; CitationJiang et al 2000; CitationZhao et al 2000; CitationAng et al 2003). Four studies showed lower rCBF in the occipital lobe, 1 in the left (CitationDeng et al 1995), the other in the right (CitationDeng et al 1997), and 2 in both sides in older-age depression (CitationJiang et al 2000; CitationAng et al 2003). Three studies also reported lower rCBF in basal ganglia, 2 on both sides (CitationDeng et al 1995; CitationJiang et al 2000), but 1 only in the right side of old patients (CitationZhao et al 2000). Three studies dealt with old patients with depression; the results showed lower rCBF in the right parietal lobe (CitationZhao et al 2000; CitationAng et al 2003), and only 1 study showed lower rCBF in the left parietal in the activated state (CitationZhao et al 1998). Patients in the studies of CitationJiang et al (2000) and CitationAng et al (2002) were the same. Only CitationDeng (1997) reported lower rCBF in cingulate, and only CitationJiang et al (2000) in the thalamus. Perfusion asymmetry in temporal, frontal, and occipital lobes was observed in 2 studies, with lower perfusion in the left than in the right. Also perfusion in the thalamus was lower in the right than in the left (CitationDeng et al 1997; CitationAng et al 2003). Three studies used patients with first-episode depression (CitationZhao et al 1998; CitationJiang et al 2000; CitationAng et al 2003).
Alzheimer’s disease
We found that all of the 8 papers dealing with AD reported lower rCBF in frontal, temporal, and parietal lobes () (CitationJia and Gao 1996; CitationLiu et al 1997; CitationAng, Jiang, et al 1998; CitationAng, Zhang, et al 1998; CitationAng et al 1999; CitationXu, Zheng, et al 1999; CitationPeng et al 2001; CitationAng et al 2002). In contrast, 3 of 9 studies did not find that rCBF was significantly lower in the frontal lobe of patients with vascular dementia (VD) (CitationAng, Zhang, et al 1998; CitationAng et al 1999; CitationXu, Huang et al 1999).
Table 2 A review of SPECT studies on Alzheimer’s disease in China
Three articles showed that rCBF was also lower in the basal ganglia of patients with VD (CitationAng, Jiang, et al 1998; CitationXu, Zheng et al 1999; CitationPeng et al 2001), but CitationXu, Huang et al (1999) found the same result only in patients with Parkinson’s disease (PD), not in the VD group. Three authors found rCBF to be lower in the thalamus of VD patients (CitationAng, Jiang, et al 1998; CitationXu, Huang, et al 1999; CitationPeng et al 2001), and 1 reported lower perfusion of rCBF in the hippocampus of AD patients (CitationPeng et al 2001). There were 5 reports of lower rCBF in the occipital lobe (CitationLiu et al 1997; CitationAng, Jiang, et al 1998; CitationAng, Zhang, et al 1998; CitationAng et al 1999; CitationXu, Huang, et al 1999), 4 in patients with VD and 1 in AD. rCBF in frontal, temporal, and parietal lobes in patients with AD was significantly lower than in patients with VD, some bilaterally and others in the right lobes only (CitationAng, Zhang, et al 1998; CitationAng et al 1999; CitationXu, Zheng, et al 1999).
Schizophrenia
Because 3 of the 13 papers about schizophrenia overlapped with other articles, we have included only 10 papers in . Most were controlled studies, with only 2 reports on schizophrenia patients without controls (CitationLi, Deng, et al 1996; CitationLiu et al 1997). We found low rCBF in the frontal lobe of patients with schizophrenia in all 10 papers. Some were in the left frontal, others in the right, and some bilateral. Six studies reported lower rCBF also in the temporal lobe in schizophrenia (CitationLi, Deng, et al 1996; CitationLi, Tang, et al 1996; CitationLi, Zhao, et al 1996; CitationLi et al 2001, Citation2002; CitationLiu et al 2002). Three authors found lower rCBF in the parietal lobe (CitationLi, Deng, et al 1996; CitationZhou et al 2001; CitationLiu et al 2002). Two reports found lower rCBF also in basal ganglia (CitationLi, Zhao, et al 1996; CitationLiu et al 2002), but there were only single reports of lower rCBF in the occipital lobe, thalamus, or cingulate respectively (CitationLi, Deng, et al 1996; CitationZhou et al 2001; CitationLiu et al 2002). Two reports measured changes of rCBF before and after antipsychotic treatment; 1 reported that rCBF increased by about 50% along with the positive symptoms but did not identify individual antipsychotics, while the other study detected no significant change after risperidone therapy for 8 weeks (CitationZhou et al 2001; CitationLiu et al 2002).
Table 3 A review of SPECT studies on schizophrenia in China
We found only 1 paper on OCD, 1 in anxiety disorder, and 1 in heroin addicts (). rCBF was low in many brain regions such as frontal, temporal, parietal, occipital, thalamus, basal ganglia, vermis, pons, amygdala, precuneus, putamen, cingulated, and orbital gyrus. More studies are needed in these psychiatric disorders in patients in China.
Table 4 A review of SPECT studies on other mental disorders in China
Discussion
To date, only 6 SPECT studies have been made on depression in China. rCBF was significantly lower in many brain regions, eg, frontal, temporal, parietal, occipital, basal ganglia, cingulate, and thalamus. While all of the studies found rCBF to be low mainly in the frontal, and to be related to depression in the basal state, some researchers found rCBF to be lower in the right but others in the left or even to be bilateral frontal. Most reported that rCBF was also low in temporal, parietal, and occipital lobes during depression. The results of low rCBF in frontal and temporal lobes in China are similar to those in North American and Japanese patients (CitationMayberg et al 1994; CitationIto et al 1996; CitationMeltzer et al 1998; CitationNobler et al 1999). So it seems that the frontal cortex plays an important role in the expression of depression (CitationAriel et al 2004). Three reports about old patients with depression in showed low rCBF low perfusion in basal ganglia (CitationJiang et al 2000; CitationZhao et al 2000; CitationAng 2003), which agrees with findings in North American patients (CitationBuchsbaum et al 1997; CitationBrody et al 2001). Only 1 paper (CitationDeng et al 1997) found that low rCBF in cingulate was correlated with depression in Chinese patients, which supports the original results in North America of CitationAustin et al (1992).
The first SPECT study in Alzheimer’s disease (AD) was reported early in 1990 (CitationBattistein et al 1990). Many nonChinese reports confirmed that perfusion of rCBF was significantly lower in temporal and parietal lobes of patients with AD (CitationFormarelli et al 1996). Chinese studies in showed that the rCBF was significantly lower in frontal, temporal and parietal lobe of patients with AD than that of control subjects. Some researchers found rCBF asymmetry in right and left; CitationAng, Jiang, et al (1998) reported that rCBF was lower in left than in right temporal lobe in AD, and lower in left than in right temporal, parietal, and occipital lobes in the VD group. CitationCelsis et al (1997) considered that asymmetry of hypoperfusion in the temporal–parietal lobe was a predictor of cognitive defect to differentiate AD from aging-related cognitive changes in North American patients. CitationAng, Zhang, et al (1998) found that rCBF in AD was lower in bilateral frontal and right parietal lobes than in VD, but also reported lower perfusion of rCBF in the right temporal and right occipital in AD than that in VD; left parietal rCBF in AD was also higher than that of the VD group (CitationAng, Jiang, et al 1998).
CitationPeng et al (2001) found the severity of AD to be associated with low perfusion of rCBF in the hippocampus. Four of 8 papers including VD patients did not show low rCBF in the frontal lobe (CitationJia et al 1996; CitationAng, Zhang, 1998; CitationAng et al 1999; CitationXu, Huang, et al 1999). Some investigators also found lower rCBF in the thalamus and basal ganglia in patients with VD (CitationLiu et al 1997; CitationAng, Jiang, et al 1998; CitationXu, Huang, et al 1999; CitationPeng et al 2001), but the results for the occipital lobe were contradictory.
Schizophrenia is a common disorder. According to the 10 papers listed in , all researchers found that rCBF perfusion was significantly lower in the frontal lobe of patients with schizophrenia, many of them showing problems also in the left side. Most of the studies (CitationJia and Gao 1996; CitationAng, Zhang, et al 1998) in also showed lower rCBF occurring in the temporal lobe, with some reporting lower rCBF bilaterally and others finding it in the right or left temporal lobe; the results at present are inconsistent. These results are similar to those in nonChinese patients (CitationAndreasen et al 1992; CitationWolkin et al 1992; CitationWoods et al 1992). CitationLi, Guifang, et al (1996) found that there was no significant difference between negative and positive symptoms in terms of lower perfusion of rCBF, both types being associated with lower rCBF in the brain, but CitationYu et al (1998) and CitationLi et al (2001) reported that the negative symptoms of schizophrenia might be related to the perfusion of rCBF in the left frontal lobe. CitationAndreasen et al (1992) and CitationRubin et al (1994) found similar results in nonChinese patients.
After treatment with risperidone, CitationLi et al (2001) found that perfusion in the thalamus and superior posterior temporale was decreased significantly, with parallel improvement in positive symptoms, similar to that in nonChinese reports (CitationBerman et al 1996; CitationSabri et al 1997; CitationMalaspina et al 1999; CitationPuri et al 2001).
For late-onset schizophrenia, CitationLiu et al 2002 found lower rCBF in the left frontal, left parietal, bilateral temporal, bilateral basal ganglia, and right thalamus (CitationLiu et al 2002), similar to the nonChinese results of CitationLesser et al (1993), CitationDupont et al (1994), and CitationSachdev et al (1997).
There were few studies of other mental disorders in China, with only 1 paper on OCD, one on anxiety disorders, and one on heroin addicts (). CitationLi et al (2002) found that the results of rCBF were different with different ways of analysis, rCBF being lower in the right anterior temporal, temporo-parietal, and left temporo-occipital lobes of patients with OCD using the regions of interest (ROI) method, but low in bilateral putamen, superior temporal gyrus, precuneus, right orbital gyrus, superior and middle frontal gyrus, left temporo-occipital lobes, superior parietal gyrus, vermis with SPM analysis. CitationWan et al (2002) found that rCBFs of brain were generally decreased under stressor stimulation, similar to the findings in nonChinese patients of CitationLucky et al (1997). CitationWan et al (2002) did not find low perfusion in the cerebellum, but CitationBonne et al (2003) found the abnormality in nonChinese PTSD patients. CitationWang et al (2003) indicted that frontal, temporal, and amygdala rCBF changes were associated with relapsing processes during exposure to heroin-related cues.
According to all the above studies, we found that perfusion of rCBF was abnormal in mental disorders, but the specificity of the abnormality is not consistent. From , we know that lower rCBF could be seen mostly in frontal, temporal, and parietal lobes of patients with depression, AD, schizophrenia, and VD. It seems that the abnormality of the frontal lobe is more common in depression and schizophrenia, but temporal lobe abnormality is more common in AD and VD. The perfusion of rCBF in the parietal lobe seems related to aging, because older patients seem to have lower perfusion of rCBF. The abnormality in the occipital lobe and basal ganglia seems to have an association with vascular problems according to the results presented in , supporting the hypothesis of vascular depression for old patients. The problem in the thalamus was correlated mainly with VD, and in the cingulate largely with depression and schizophrenia. One paper found AD associated with the hippocampus. There were few reports of anxiety disorders and other mental problems. It seems likely that brain abnormalities in Chinese psychiatric patients are similar to those in nonChinese populations, at least as measured by rCBF changes in SPECT studies. We need multicenter, large-sample, same-diagnosis-criteria, prospective, controlled, collaborative studies across populations to provide more specific information on the pathophysiology in mental disorders.
Table 5 A comparison of rCBF distribution of SPECT in depression, AD, VD, and schizophrenia
References
- AndreasenNCRezaiKAlligerR1992Hypofrontality in neuroleptic-naïve patients with chronic schizophreniaArch Gen Psychiatry49943501360199
- AngQiuqingJiangKaidaZhaoJinhua1998Application of SPECT in diagnosis of in Alzheimer disease and vascular dementiaChin J Med Computer Imag4198201
- AngQiuqingZhangMingyuanZhaoJinhua1998SPECT study in Alzheimer disease, vascular dementia and normal old personsShanghai Arch Psychiatry10Suppl424
- AngQiuqingJiangKaidaHuangYanyan1999Neuropsychology and its correlation with cerebral blood flow in patients with Alzheimer disease, vascular dementia and normal seniorsChin J Nucl Med191936
- AngQiuqingJiangKaidaZhangMingyuan2002Brain imaging study on Alzheimer disease with single-photon emission computed tomography and magnetic resonanceChin J Psychiatry35826
- AngQiuqingJiangKaidaZhangMingyuan2003SPECT study on elderly depressionChin J Nerv Ment Dis292725
- ArielGGJorgeGOYazninME2004Correlation between cerebral blood flow and items of the Hamlton rating scale for depression in antidepressant-naïve patientsJ Affect Disord80556215094258
- AustinMPDougallNRossM1992Single photon emission tomography with 99mTc-exametazime in major depression and the pattern of brain activity underlying the psychotic/neurotic continuumJ Affect Disord2631431430666
- BattisteinLPizzdatoGDamM1990rCBF study with 99m TC-HMPAO SPECT in Alzheimer’s and multi-infarct dementiaEur Neurol302963012269322
- BermanIMersonASisonC1996Regional cerebral blood flow changes associated with risperidone treatment in elderly schizophrenia patients: a pilot studyPsychopharmacol Bull329598927682
- BonneOGilboaALouzounY2003Resting regional cerebral perfusion in recent posttraumatic stress disorderBiol Psychiatry5410778614625150
- BrodyALSaxenaSStoesselP2001Regional brain metabolic change in patients with major depression treated with either paroxetine or interpersonal therapy: preliminary findingsArch Gen Psychiatry586314011448368
- BuchsbaumMSWuJSiegelBV1997Effect of sertraline on regional metabolic rate in patients with affective disorderBiol Psychiatry411528988791
- CelsisPAgnielACardebatD1997Age related cognitive decline: a clinical entity? A longitudinal study of cerebral blood flow and memory perfomanceJ Neurol Neurosurg Psychiatry6260189219746
- DengHongBaiPeishenLiXianfeng1997SPECT study in depressionChin J Psychiatry301968
- DengHongMaJingtangBaiPeishen1995A pilot study of SPECT in depressionJ Shanxi Med Coll26313
- DupontRMLehrPPLamoureauxG1994Preliminary report: cerebral blood flow abnormalities in older schizophrenic patientsPsychiatry Res55121307870852
- FormarelliDAscoliGRossiR1996Clinical and instrumental diagnosis of Alzheimer’s and multi-infarct dementiaRadiol Med (Torino)922278966268
- HuPingWuKeningZenShiquan1996Regional cerebral blood flow of the patients with schizophreniaChin J Nucl Med16109111
- ItoHKawashimaRAwataS1996Hypofusion in limbic system and perfusion cortes in depression: SPECT with anatomic standardization techniqueJ Nucl Med37410148772633
- JiaZhirongGaoSurong1996Study of CT and SPECT in Alzheimer disease and vascular dementiaChin Ment Health J101245
- JiangKaidaAngQiuqingZhangMingyuan2000Neuropsychological and SPECT study in elderly depressionShanghai Arch Psychiatry1269
- LesserIMMillerBLSwartzJR1993Brain imaging in late-life schizophrenia and related psychosesSchizophr Bull19773828303226
- LiHuafangGuNiufanXiuYan2001The regional cerebral blood flow of naïve schizophrenia before and after drug treatment by brain SPECT imagingChin J Nerv Ment Dis2799102
- LiHuafangXiuYanChenShaoliang2002Baseline and activated regional cerebral flow of naïve paranoid schizophrenicsChin J Nucl Med2234851
- LiPeiyongJiangXufengZhangLiying2002Study of regional cerebral blood flow in obsessive compulsive disorder patients with SPM and ROI methodChin J Nucl Med22879
- LiXianfengDengHongBaiPeishen1996The study of regional cerebral blood flow in patients with schizophrenia and depressionJ Shanxi Med Coll2721315
- LiXinbaoTangJishengZhaoGuifang1996An imaging study of brain function with SPECT in patients with schizophreniaChin J Psychiatry291922
- LiXinbaoZhaoGuifangTangJisheng1996A related study of negative symptoms of schizophrenia and regional cerebral blood flowChin J Nerv Ment Dis223425
- LiuDengtangJiangKaidaYangXiaomin2002Regional cerebral blood flow and cognitive deficits in late-onset schizophrenic patientsChin J Psychiatry35914
- LiuTaiyunJinLijuanOuYangsan1997Relationship between regional cerebral blood flow and neuropsychological functions in dementia of multi-infarct and Alzheimer typeChin J Clin Psychol51557
- LiuZheningYangLinglingSuJianzhi1997Relationship between regional cerebral blood flow and Wisconsin card sorting test in negative schizophreniaChin J Clin Psychol5957
- LuckyJVCostaDCAdsheadG1997Brain blood flow in anxiety disorders, OCD, panic disorder with agoraphobia and post-traumatic stress disorder on 99Tcm-HMPAO single photon emission tomography (SPECT)Br J Psychiatry171346509373423
- MalaspinaDStorerSFurmanV1999SPECT study of visual fixation in schizophrenia and comparison subjectsBiol Psychiatry46899310394477
- MaybergHSLewisPJRegenoldW1994Paralimbic hypoperfusion in unipolar depressionJ Nucl Med35929348195877
- MeltzerCCSmithGDekoskyST1998Serotonin in aging, late-life depression, and Alzheimer’s disease: the emerging role of functional imagingNeuropsychopharmacology18407109571651
- NoblerMSMannJJSackeimHA1999Serotonin, cerebral blood flow, and cerebral metabolic rate in geriatric major depression and normal agingBrain Res Rev302506310567727
- PengDantaoXuXianhaoChaiXiaojie2001The diagnostic study on MRI and SPECT for the dementiaChin J Geriatr2017881
- PuriBKLekhSKNijiranKS2001SPECT neuroimaging in schizophrenia with religious delusionsInt J Psychophysiol40143811165352
- RubinPHemmingsenRHolmS1994Relationship between brain structure and function in disorders of the schizophrenic spectrum: single position emission computerized tomography, computerized tomography and psychopathology of first episodeActa Psychiatr Scand9028167831999
- SabriOErkwohRSchreckenbergerM1997Regional cerebral blood flow and negative/positive symptoms in 24 drug-naïve schizophrenicsJ Nucl Med3818189025731
- SachdevPBrodatyHRoseN1997Regional cerebral blood flow in late-onset schizophreniaSchizophr Res27105179416641
- WanLiLiuJianWuWenyuan2002A study on regional cerebral blood flow at rest and stress state in anxiety disorder patientsChin J Nucl Med222068
- WangZhengqingZhaoGeyuanLiuQinglong2003The SPECT study on the regional cerebral blood flow of heroin addicts during cue-induced heroin cravingChin J Nucl Med2327980
- WolkinASanfilipoMWolfAP1992Negative symptoms and hypofrontality in chronic schizophreniaArch Gen Psychiatry49959651360200
- WoodsSWRegional cerebral blood flow imaging with SPECT in psychiatric disease: focus on schizophrenia, anxiety disorders, and substance abuse1992J Clin Psychiatry53Suppl2051459979
- XuJingZhengLishaZhangYanjun1999The change of cerebral circulation in the patients with senile dementiaJ Chin Neurol1221012
- XuYifengHuangYanyanJiangKaida1999The comparison of vascular dementia and Parkinson disease using neuropsychological tests and single photon emission computed tomographyChin J Psychiatry321457
- YuJinglongHuPingMaiGuiying1998Negative symptoms and frontal lobe dysfunction in schizophreniaJ Clinical Psychiatry81936
- ZhaoJinhuaLinXiangtongJiangKaida1998Baseline and cognition activated brain SPECT imagine in depressionChin J Nucl Med18702
- ZhaoJinhuaLinXiangtongJiangKaida2000Baseline and cognition activated brain SPECT imaging of adult and elderly patients with depressionChin J Nucl Med201658
- ZhouDehuaiMoYaopuSheLiqun2001The diagnostic value study of the brain perfusion SPECT imaging in schizophreniaChina JMIT179557