Department of Neurology,the First Affiliated Hospital of Anhui Medical University,Hefei, 230022,China.
Anhui Mental Health Center,Hefei, Anhui Province,China.
Psychol Med. 2019 Jun;49(8):1357-1364. doi: 10.1017/S0033291718002684. Epub 2018 Sep 19.
Electroconvulsive therapy (ECT), an effective antidepressive treatment, is frequently accompanied by cognitive impairment (predominantly memory), usually transient and self-limited. The hippocampus is a key region involved in memory and emotion processing, and in particular, the anterior-posterior hippocampal subregions has been shown to be associated with emotion and memory. However, less is known about the relationship between hippocampal-subregion alterations following ECT and antidepressant effects or cognitive impairments.
Resting-state functional connectivity (RSFC) based on the seeds of hippocampal subregions were investigated in 45 pre- and post-ECT depressed patients. Structural connectivity between hippocampal subregions and corresponding functionally abnormal regions was also conducted using probabilistic tractography. Antidepressant effects and cognitive impairments were measured by the Hamilton Depressive Rating Scale (HDRS) and the Category Verbal Fluency Test (CVFT), respectively. Their relationships with hippocampal-subregions alterations were examined.
After ECT, patients showed increased RSFC in the hippocampal emotional subregion (HIPe) with the left middle occipital gyrus (LMOG) and right medial temporal gyrus (RMTG). Decreased HDRS was associated with increased HIPe-RMTG RSFC (r = -0.316, p = 0.035) significantly and increased HIPe-LMOG RSFC at trend level (r = -0.283, p = 0.060). In contrast, the hippocampal cognitive subregion showed decreased RSFC with the bilateral angular gyrus, and was correlated with decreased CVFT (r = 0.418, p = 0.015 for left; r = 0.356, p = 0.042 for right). No significant changes were found in structural connectivity.
The hippocampal-subregions functional alterations may be specially associated with the antidepressant and cognitive effects of ECT.
电抽搐治疗（ECT）是一种有效的抗抑郁治疗方法，但其常伴有认知障碍（主要是记忆障碍），通常是短暂的、自限性的。海马体是参与记忆和情绪处理的关键区域，特别是前后海马亚区与情绪和记忆有关。然而，我们对 ECT 后海马亚区改变与抗抑郁作用或认知障碍的关系知之甚少。
对 45 例接受 ECT 前后的抑郁症患者进行基于海马亚区种子的静息态功能连接（RSFC）研究。还使用概率追踪技术对海马亚区与相应功能异常区域之间的结构连接进行了研究。采用汉密尔顿抑郁评定量表（HDRS）和类别流畅性测验（CVFT）分别测量抗抑郁作用和认知障碍。考察了它们与海马亚区改变的关系。
ECT 后，患者的左中枕叶（LMOG）和右内侧颞叶（RMTG）与海马情绪亚区（HIPe）的 RSFC 增加，HDRS 降低与 HIPe-RMTG RSFC 增加显著相关（r=-0.316，p=0.035），HIPe-LMOG RSFC 呈趋势性增加（r=-0.283，p=0.060）。相反，海马认知亚区与双侧角回的 RSFC 降低，与 CVFT 降低相关（左侧：r=0.418，p=0.015；右侧：r=0.356，p=0.042）。结构连接未发现显著变化。
海马亚区功能改变可能与 ECT 的抗抑郁作用和认知作用特别相关。
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