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Complete Normalization of Severe Brain 18F-FDG Hypometabolism Following Electroconvulsive Therapy in a Major Depressive Episode

Lajoie, Cédrik MD; Levasseur, Marc-André MD; Paquet, Nancy MD, FRCPC

doi: 10.1097/RLU.0b013e31829b9bd9
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We describe a patient with a complex neuropsychiatric disorder who presented a severe and diffuse cerebral glucose hypometabolism on 18F-FDG PET initially which, in the clinical setting, was suspicious of an advanced neurodegenerative disease. Further evaluation suggested a major depressive episode with agitation and poor response to medication. Electroconvulsive therapy (ECT) brought excellent results. A follow-up cerebral 18F-FDG PET was completely normal, thus illustrating the potential for complete recovery and normalization of brain metabolism in major depressive episode following ECT. It also shows the risk of false interpretation of brain PET in patients with depression.

From the Nuclear Medicine and Radiobiology Department, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Canada.

Received for publication October 30, 2012; revision accepted May 11, 2013.

Conflicts of interest and sources of funding: none declared.

C.L.: Design, review of literature, writing of the manuscript and production of illustrations, final approval.

M.-A.L.: Design, review of literature, revision of the manuscript, final approval.

N.P.: Design, expert opinion, revision of the manuscript, final approval.

Reprints: Nancy Paquet, CHUS, département de médecine nucléaire et de radiobiologie, 3001, 12e Avenue N., Sherbrooke, QC, Canada, J1H 5N4. E-mail:

© 2013 by Lippincott Williams & Wilkins