An increased occurrence of major depressive disorder has been reported in tinnitus patients, and of tinnitus
in depressive patients. Involvement of several Brodmann areas (BAs) has been reported in tinnitus
perception. The aim of this study was to assess the regional cerebral blood flow (rCBF) changes in
depressed patients with and without tinnitus. The rCBF distribution at rest was compared among 45
patients with a lifetime prevalence of major depressive disorder, of whom 27 had severe tinnitus, and 26
normal healthy subjects. 99m Tc-hexamethylenepropylene amine oxime ( 99m Tc-HMPAO) single photon
emission computed tomography (SPECT), using a three-headed gamma camera, was performed and the
uptake in 34 functional sub-volumes of the brain bilaterally was assessed by a computerized brain atlas.
Decreased rCBF in right frontal lobe BA 45 (P50.05), the left parietal lobe BA 39 (P50.00) and the left
visual association cortex BA 18 (P50.05) was found in tinnitus patients compared with non-tinnitus
patients. The proportion of tinnitus patients with pronounced rCBF alterations in one or more of the
temporal lobe BAs 41+21+22 was increased compared to gender matched controls (P50.00) and patients
without tinnitus (P50.05). Positive correlations were found between trait anxiety scales from the
Karolinska Scales of Personality and rCBF in tinnitus patients only in three limbic BAs (P50.01), and
inverse correlations in non-tinnitus patients only in five BAs subserving auditory perception and
processing (P50.05). rCBF differences between healthy controls and depressed patients with and without
tinnitus were found in this study. The rCBF alterations were distributed in the cortex and were particularly
specific in the auditory cortex. These findings suggest that taking audiological symptoms into account may
yield more consistent results between rCBF studies of depression.
