Yrondi Antoine, Nemmi Federico, Billoux Sophie, Giron Aurélie, Sporer Marie, Taib Simon, Salles Juliette, Pierre Damien, Thalamas Claire, Schmitt Laurent, Péran Patrice, Arbus Christophe
Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante FondaMental, CHU Toulouse, Hospital Purpan, ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France.
ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France.
Front Psychiatry. 2019 Sep 19;10:694. doi: 10.3389/fpsyt.2019.00694. eCollection 2019.
The hippocampus plays a key role in depressive disorder, and the amygdala is involved in depressive disorder through the key role that it plays in emotional regulation. Electroconvulsive therapy (ECT) may alter the microstructure of these two regions. Since mean diffusivity (MD), is known to be an indirect marker of microstructural integrity and can be derived from diffusion tensor imaging (DTI) scans, we aim to test the hypothesis that treatment-resistant depression (TRD) patients undergoing bilateral (BL) ECT exhibit a decrease of MD in their hippocampus and amygdala. Patients, between 50 and 70 years of age, diagnosed with TRD were recruited from the University Hospital of Toulouse and assessed clinically (Hamilton Depression Rating Scale, HAM-D) and by DTI scans at three time points: baseline, V2 (during treatment), and V3 within 1 week of completing ECT. We included 15 patients, who were all responders. The left and right hippocampi and the left amygdala showed a significant decrease in MD at V3, compared to baseline [respectively: β = -2.78, t = -1.97, p = 0.04; β = -2.56, t = -2, p = 0.04; β = -2.5, t = -2.3, p = 0.04, false discovery rate (FDR) corrected]. MD did not decrease in the right amygdala. Only the left amygdala was significantly associated with a reduction in HAM-D (ρ = 0.55, p = 0.049, FDR corrected). MD is an indirect microstructural integrity marker, which decreases in the hippocampus and the left amygdala, during BL ECT in TRD populations. This could be interpreted as a normalization of microstructural integrity in these structures.
海马体在抑郁症中起关键作用，而杏仁核通过其在情绪调节中所起的关键作用参与抑郁症。电休克治疗（ECT）可能会改变这两个区域的微观结构。由于平均扩散率（MD）是微观结构完整性的间接标志物，且可从扩散张量成像（DTI）扫描中得出，我们旨在检验这一假设：接受双侧（BL）ECT治疗的难治性抑郁症（TRD）患者海马体和杏仁核中的MD会降低。从图卢兹大学医院招募了年龄在50至70岁之间、被诊断为TRD的患者，并在三个时间点进行临床评估（汉密尔顿抑郁量表，HAM-D）和DTI扫描：基线、V2（治疗期间）和ECT完成后1周内的V3。我们纳入了15名患者，他们均为治疗有效者。与基线相比，左侧和右侧海马体以及左侧杏仁核在V3时MD显著降低[分别为：β = -2.78，t = -1.97，p = 0.04；β = -2.56，t = -2，p = 0.04；β = -2.5，t = -2.3，p = 0.04，经错误发现率（FDR）校正]。右侧杏仁核的MD没有降低。只有左侧杏仁核与HAM-D的降低显著相关（ρ = 0.55，p = 0.049，经FDR校正）。MD是一种间接的微观结构完整性标志物，在TRD人群的BL ECT治疗期间，海马体和左侧杏仁核中的MD会降低。这可以解释为这些结构中微观结构完整性的正常化。
