Effect of sleep deprivation on brain metabolism of depressed patients

Sleep deprivation has been shown to have a rapid, nonpharmacologic antidepressant effect in studies involving over 1,500 patients (1-3). In normal subjects sleep deprivation is associated with diminished vigilance and decreased metabolism in the thalamus and midbrain, according to studies using positron emission tomography (PET) (4). Since normal and depressed subjects seem to have different responses to sleep deprivation (1), a different regional metabolic response to sleep deprivation might well occur in such patients, perhaps involving the cingulate and other limbic structures. The limbic system has been hypothesized to be involved in mood (5). In this report we present the results of what we believe to be the first study of sleep deprivation in depression using PET with [18F]deoxyglucose (FDG) to assess limbic system metabolic correlates of mood and the antidepressant effects of sleep deprivation.