Non-Invasive Neurostimulation Therapies (NINET) Laboratory, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1, Canada.
Department of psychiatry, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
J Affect Disord. 2021 May 1;286:40-48. doi: 10.1016/j.jad.2021.02.051. Epub 2021 Feb 26.
Magnetic Seizure therapy (MST) is an effective treatment for major depressive disorder (MDD) but its mechanism of action is not fully understood. The present study sought to characterize neuroimaging correlates of response and side effects of MST in a MDD cohort.
Fifteen severe MDD patients underwent a six-day course of MST treatment to the vertex. Before and after treatment, participants received rs-fMRI and structural MRI scans as well as assessments of depressive symptoms and neuropsychological functioning. 10 healthy volunteers received functional and structural MRI scans at similar time intervals.
MST treatment was associated with increased functional connectivity between the subgenual anterior cingulate cortex (sgACC) and the parietal cortex, which positively correlated with clinical improvement. In contrast, greater decrease in functional connectivity between the right anterior hippocampus and the prefrontal cortex was correlated with lesser clinical and cognitive improvements. Changes in gray matter volume were evident in the bilateral parietal cortex, but were not associated with treatment outcomes.
The sample size was small and results warrant replication.
This is the first quantitative fMRI study to investigate the neural correlates of MST treatment for MDD patients. While preliminary, these findings suggest that the modulation of sgACC activity is integral to the antidepressant mechanisms of MST. In contrast, changes in the hippocampus were not associated with symptom improvement, and appeared to contribute instead to side effects. Future studies in larger samples are warranted and explore the effect of e-electric field and correlates of response.
磁惊厥疗法（MST）是一种治疗重度抑郁症（MDD）的有效方法，但它的作用机制尚不完全清楚。本研究旨在探讨 MST 治疗 MDD 患者的反应和副作用的神经影像学相关性。
15 名重度 MDD 患者接受了为期六天的 MST 治疗，治疗部位为顶点。治疗前后，参与者接受了 rs-fMRI 和结构 MRI 扫描，以及抑郁症状和神经心理学功能评估。10 名健康志愿者在相似的时间间隔接受了功能和结构 MRI 扫描。
MST 治疗与前扣带回皮质（sgACC）和顶叶之间的功能连接增加有关，这种连接与临床改善呈正相关。相比之下，右侧前海马和前额叶之间的功能连接减少与临床和认知改善较少相关。双侧顶叶的灰质体积变化明显，但与治疗结果无关。
样本量较小，结果需要复制。
这是第一项定量 fMRI 研究，旨在探讨 MST 治疗 MDD 患者的神经影像学相关性。虽然初步结果表明，sgACC 活动的调节是 MST 抗抑郁机制的重要组成部分。相比之下，海马体的变化与症状改善无关，而是可能与副作用有关。未来的研究需要在更大的样本中进行，并探讨电场的影响和反应的相关性。
