Alterations of rCBF and mitochondrial dysfunction in major depressive disorder: a case report.

Background. A mitochondrial disease might be considered when depressive disorder is associated with diabetes mellitus or other symptoms commonly found in mitochondrial disease. Scattered rCBF decreases and increases have been reported in depressive and mitochondrial disorders. Method. A 61-year old male patient with early adult onset of depressive disorder and a slowly developing multiorgan syndrome including diabetes mellitus was investigated with 99mTc-HMPAO rCBF SPECT, and muscle biopsy to assess mitochondrial functions. Results. Alterations of rCBF were found in the patient, with the most pronounced decreases in the left dorsolateral frontal and inferior parietal lobes, and the most pronounced increases in the bilateral superior parietal lobe. Muscle biopsy revealed myopathy and decrease of mitochondrial ATP production rates (MAPRs). Conclusion. The MAPRs decreases support the suspicion of mitochondrial dysfunction in the patient. A subgroup of depressed patients may have mitochondrial dysfunctions.