Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.
Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Neuroscience Research Center, Berlin Institute of Health, Berlin, Germany; Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada; Department of Psychiatry, University of Calgary, Calgary, AB, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
J Affect Disord. 2020 Mar 1;264:163-171. doi: 10.1016/j.jad.2019.11.120. Epub 2019 Nov 29.
Electroconvulsive therapy (ECT) can lead to rapid and effective responses in major depressive disorder (MDD). However, the precise neural mechanisms of ECT for MDD are still unclear. Previous work has confirmed that thalamocortical circuits play an important role in emotion and cognition. However, the relationship between mechanisms of ECT for MDD and thalamocortical connectivity has not yet been investigated.
Thalamocortical functional connectivity analysis was performed on resting-state functional magnetic resonance imaging (fMRI) data collected from 28 MDD patients both pre- and post-ECT treatment, as well as 20 healthy controls. The cortex was parceled into six regions of interest (ROIs), which were used as seeds to assess the functional connectivity between the cortex and each voxel in the thalamus. Then, functional connectivity between the identified thalamic subregions and the rest of the brain was quantified to better localize thalamocortical connectivity related to ECT. Structural connectivity among the functionally abnormal regions was also determined using probabilistic tractography from diffusion tensor imaging (DTI) data.
There was decreased parietal cortex-left pulvinar and left pulvinar-bilateral precuneus functional connectivity in post-ECT MDD patients, compared to pre-ECT MDD patients. Furthermore, functional connectivity strength of parietal cortex-left pulvinar and left pulvinar-bilateral precuneus was negative correlation with verbal fluency test scores in post-ECT MDD patients. No significant change was found in structural connectivity analysis.
The sample size of our study was not large.
Our findings implicate that the specific abnormalities in thalamocortical circuit may be associated with cognitive impairment induced by ECT.
电抽搐治疗（ECT）可在重度抑郁症（MDD）中迅速有效地产生反应。然而，ECT 治疗 MDD 的精确神经机制仍不清楚。先前的研究已证实丘脑皮质回路在情绪和认知中起着重要作用。但是，MDD 的 ECT 机制与丘脑皮质连接之间的关系尚未得到研究。
对 28 例 MDD 患者进行了电抽搐治疗前后的静息状态功能磁共振成像（fMRI）数据的丘脑皮质功能连接分析，以及 20 名健康对照者。将皮质分为 6 个感兴趣区（ROI），将其作为种子，以评估皮质与丘脑每个体素之间的功能连接。然后，量化了确定的丘脑亚区与大脑其余部分之间的功能连接，以更好地定位与 ECT 相关的丘脑皮质连接。还使用扩散张量成像（DTI）数据的概率追踪确定了功能异常区域之间的结构连接。
与 MDD 患者的 ECT 前相比，ECT 后 MDD 患者的顶叶皮质-左侧丘脑枕和左侧丘脑枕-双侧楔前叶功能连接降低。此外，在 ECT 后 MDD 患者中，顶叶皮质-左侧丘脑枕和左侧丘脑枕-双侧楔前叶的功能连接强度与言语流畅性测试分数呈负相关。结构连接分析未发现明显变化。
我们研究的样本量不大。
我们的研究结果表明，丘脑皮质回路的特定异常可能与 ECT 引起的认知障碍有关。
