Takamiya Akihiro, Kishimoto Taishiro, Liang Kuo-Ching, Terasawa Yuri, Nishikata Shiro, Tarumi Ryosuke, Sawada Kyosuke, Kurokawa Shunya, Hirano Jinichi, Yamagata Bun, Mimura Masaru
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Center for Psychiatry and Behavioral Science, Tokyo, Japan.
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
J Psychiatr Res. 2019 Oct;117:135-141. doi: 10.1016/j.jpsychires.2019.08.001. Epub 2019 Aug 7.
Electroconvulsive therapy (ECT) is the most effective antidepressant treatment. Biological predictors of clinical outcome to ECT are valuable. We aimed to examine multimodal magnetic resonance imaging (MRI) data that correlates to the efficacy of ECT. Structural and resting-state functional MRI data were acquired from 46 individuals (25 depressed individuals who received ECT, and 21 healthy controls). Whole-brain grey matter volume (GMV) and fractional amplitude of low frequency fluctuations (fALFF) were investigated to identify brain regions associated with post-ECT Hamilton Depression Rating Scale (HAM-D) total scores. GMV and fALFF values were compared with those in healthy controls using analysis of covariance (ANCOVA). Remission was defined by HAM-D ≤7. A multiple regression analysis revealed that pretreatment smaller GMV in the left thalamus was associated with worse response to ECT (i.e. higher post-ECT HAM-D). Pretreatment higher fALFF in the right anterior insula, and lower fALFF in the left thalamus and the cerebellum were associated with worse outcomes. The left thalamus was identified in both GMV and fALFF analyses. Nonremitters showed significantly smaller thalamic GMV compared to remitters and controls. We found that pretreatment thalamic volume and resting-state activity were associated with the efficacy of ECT. Our results highlight the importance of the thalamus as a possible biological predictor and its role in the underlying mechanisms of ECT action.
电休克疗法（ECT）是最有效的抗抑郁治疗方法。ECT临床疗效的生物学预测指标很有价值。我们旨在研究与ECT疗效相关的多模态磁共振成像（MRI）数据。从46名个体（25名接受ECT的抑郁症患者和21名健康对照者）获取了结构和静息态功能MRI数据。研究了全脑灰质体积（GMV）和低频波动分数振幅（fALFF），以确定与ECT治疗后汉密尔顿抑郁量表（HAM-D）总分相关的脑区。使用协方差分析（ANCOVA）将GMV和fALFF值与健康对照者的值进行比较。缓解定义为HAM-D≤7。多元回归分析显示，治疗前左侧丘脑GMV较小与ECT反应较差相关（即ECT治疗后HAM-D较高）。治疗前右侧前岛叶fALFF较高，左侧丘脑和小脑fALFF较低与较差的治疗结果相关。在GMV和fALFF分析中均发现了左侧丘脑。与缓解者和对照者相比，未缓解者的丘脑GMV明显较小。我们发现治疗前丘脑体积和静息态活动与ECT疗效相关。我们的结果突出了丘脑作为一种可能的生物学预测指标的重要性及其在ECT作用潜在机制中的作用。
