Zhang Ting, He Kongliang, Bai Tongjian, Lv Huaming, Xie Xiaohui, Nie Jiajia, Xie Wen, Zhu Chunyan, Wang Kai, Tian Yanghua
Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Anhui Province, China.
Anhui Mental Health Center, Hefei, Anhui Province, China.
Prog Neuropsychopharmacol Biol Psychiatry. 2021 Jul 13;109:110193. doi: 10.1016/j.pnpbp.2020.110193. Epub 2020 Dec 5.
Anhedonia is a core characteristic of depression, the amelioration of which accounts for depressive symptom improvement. Electroconvulsive therapy (ECT) has been shown remarkable antidepressive effect, however, less is known about the effect of ECT on anhedonia and its underlying neural mechanism. Herein, we investigated local and global intrinsic brain functional alterations during the resting state in 46 patients with pre- and post-ECT major depressive disorder using the amplitude of low-frequency fluctuations (ALFF) and degree centrality (DC) approach. Functional connectivity (FC) was also calculated between nodes with significant local and global intrinsic brain functional alterations. The severity of anhedonia and depression was assessed with the Temporal Experience of Pleasure Scale and Hamilton Depression Rating Scale, respectively. The relationship between the change in anhedonia and depressive symptoms and brain functional alterations was determined. Increased ALFF and DC were observed in the bilateral dorsal medial prefrontal cortex (dmPFC), right dorsal lateral prefrontal cortex (dlPFC), left orbitofrontal cortex, and right orbitofrontal cortex (ROFC) after ECT. Correlational analysis between the change in anhedonia and ALFF had positive results in the dmPFC. Similarly, there was a positive correlation between the change in anhedonia and change in DC in the dmPFC, right dlPFC, ROFC, and middle frontal gyrus. Furthermore, there was a significant relationship between the change in anhedonia and altered dmPFC-dlPFC FC. These results revealed that amelioration of anhedonia may be associated with intrinsic neural activity alteration in the reward-related circuit and executive control network following ECT.
快感缺失是抑郁症的核心特征，其改善是抑郁症状改善的原因。电休克疗法（ECT）已显示出显著的抗抑郁作用，然而，关于ECT对快感缺失的影响及其潜在神经机制知之甚少。在此，我们使用低频波动幅度（ALFF）和度中心性（DC）方法，研究了46例ECT治疗前后重度抑郁症患者静息状态下局部和全脑内在脑功能改变。还计算了具有显著局部和全脑内在脑功能改变的节点之间的功能连接（FC）。分别用时间愉悦体验量表和汉密尔顿抑郁量表评估快感缺失和抑郁的严重程度。确定了快感缺失和抑郁症状变化与脑功能改变之间的关系。ECT治疗后，双侧背内侧前额叶皮质（dmPFC）、右侧背外侧前额叶皮质（dlPFC）、左侧眶额皮质和右侧眶额皮质（ROFC）的ALFF和DC增加。快感缺失变化与ALFF之间的相关性分析在dmPFC中呈阳性结果。同样，快感缺失变化与dmPFC、右侧dlPFC、ROFC和额中回的DC变化之间存在正相关。此外，快感缺失变化与dmPFC-dlPFC FC改变之间存在显著关系。这些结果表明，ECT治疗后快感缺失的改善可能与奖赏相关回路和执行控制网络中的内在神经活动改变有关。
