电抽搐治疗引起的灰质增加与抑郁患者的临床数据不一定相关。
Electroconvulsive therapy induced gray matter increase is not necessarily correlated with clinical data in depressed patients.
机构信息
Research Group Translational Imaging, Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany; Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
Department of Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
出版信息
Brain Stimul. 2019 Mar-Apr;12(2):335-343. doi: 10.1016/j.brs.2018.11.017. Epub 2018 Dec 4.
BACKGROUND
Electroconvulsive therapy (ECT) and depression have been associated with brain volume changes, especially in the hippocampus and the amygdala.
METHODS
In this retrospective study we collected data from individual pre-post ECT whole brain magnetic resonance imaging scans of depressed patients from six German university hospitals. Gray matter volume (GMV) changes were quantified via voxel-based morphometry in a total sample of 92 patients with major depressive episodes (MDE). Additionally, 43 healthy controls were scanned twice within a similar time interval.
RESULTS
Most prominently longitudinal GMV increases occurred in temporal lobe regions. Within specific region of interests we detected significant increases of GMV in the hippocampus and the amygdala. These results were more pronounced in the right hemisphere. Decreases in GMV were not observed. GMV changes did not correlate with psychopathology, age, gender or number of ECT sessions. We ruled out white matter reductions as a possible indirect cause of the detected GMV increase.
CONCLUSION
The present findings support the notion of hippocampus and amygdala modulation following an acute ECT series in patients with MDE. These results corroborate the hypothesis that ECT enables primarily unspecific and regionally dependent neuroplasticity effects to the brain.
背景
电抽搐疗法（ECT）和抑郁症与脑容量变化有关，尤其是在海马体和杏仁核。
方法
在这项回顾性研究中，我们从来自德国六所大学医院的接受 ECT 的抑郁症患者的个人治疗前后全脑磁共振成像扫描中收集数据。通过基于体素的形态计量学对 92 名患有重度抑郁症发作（MDE）的患者进行了总体样本的灰质体积（GMV）变化的定量。此外，43 名健康对照者在相似的时间间隔内进行了两次扫描。
结果
最明显的是颞叶区域的纵向 GMV 增加。在特定的感兴趣区域内，我们检测到 GMV 在海马体和杏仁核中显著增加。这些结果在右半球更为明显。未观察到 GMV 的减少。GMV 变化与精神病学、年龄、性别或 ECT 次数无关。我们排除了作为检测到的 GMV 增加的可能间接原因的白质减少。
结论
本研究结果支持 MDE 患者接受急性 ECT 系列治疗后海马体和杏仁核调节的观点。这些结果证实了 ECT 能够使大脑产生主要非特异性和区域依赖性神经可塑性效应的假说。
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