Regional Parieto-occipital Hypoperfusion on Arterial Spin Labeling Associates with Major Depressive Disorder

Shingo Kihira1, *, Clara Koo1, Kambiz Nael2, Puneet Belani1
1 Department of Diagnostic, Molecular and Interventional, Radiology Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave Levy Place, New York, NY10029 USA
2 Department of Radiological Sciences, David Geffen School of Medicine at University of California, Los Angeles10833 Le Conte Ave, Los Angeles, CA90095, USA

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© 2020 Kihira et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Diagnostic, Molecular and Interventional Radiology Icahn School of Medicine at Mount Sinai, Mount Sinai HospitalOne Gustave Levy Place, New York, NY10029 USA; Tel: (650) 766-3539; Fax: (212) 241-6500; E-mail:



Reduced cerebral blood flow in parieto-occipital regions has been reported in neurodegenerative disorders using ASL. We aimed to investigate neuropsychiatric and neurodegenerative comorbidities that may associate with parieto-occipital region hypoperfusion.


This was a retrospective single-center study. Between March 2017 to May 2018, adult patients who underwent brain MRI with the inclusion of ASL perfusion and who had bilateral reductions of CBF in the parieto-occipital regions were included. ASL was performed using a pseudo-continuous arterial spin labeling (pCASL) technique on 1.5T MR system. Age and gender-matched patients with no perfusion defect were concurrently collected. Comorbidity data was collected from EMR, including major depressive disorder, Alzheimer’s disease, Parkinson’s disease, Schizophrenia, anxiety disorder, hypertension, diabetes mellitus type II, coronary artery disease, and chronic kidney disease. A Pearson’s Chi-Square test was performed to assess for comorbidities associated with hypoperfusion of the parieto-occipital lobes.


Our patient cohort consisted of 93 patients with bilateral hypoperfusion in the parieto-occipital lobes and 93 age and gender-matched patients without corresponding perfusion defects based on ASL-CBF. Among the comorbidities assessed, there was a statistically significant association between hypoperfusion of the parieto-occipital lobes and major depressive disorder (p=0.004) and Parkinson’s disease (p=0.044). There was no statistically significant association for Alzheimer’s disease, generalized anxiety disorder, diabetes mellitus type II, hypertension, coronary artery disease, or chronic kidney disease.


Major depressive disorder may be linked to regional parieto-occipital hypoperfusion on ASL.

Keywords: Arterial spin labeling, Cerebral blood flow, Major depressive disorder, Parkinson’s disease, Perfusion, Parieto-occipital Hypoperfusion.