Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, University Psychiatric Center Duffel, Stationstraat 22, Duffel 2570, Belgium; Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Woluwe-Saint-Lambert, Belgium.
Department of Psychiatry, Radboud University Medical Centre, Huispost 961, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behavior, Centre for Neuroscience, P.O. Box 9010, 6500 GL Nijmegen, the Netherlands.
J Affect Disord. 2021 Jul 1;290:117-127. doi: 10.1016/j.jad.2021.04.069. Epub 2021 May 3.
Electroconvulsive therapy (ECT) is a highly effective treatment for depression but how it achieves its clinical effects remains unclear.
We set out to study the brain's response to ECT from a large-scale brain-network perspective. Using a voxelwise analysis, we looked at resting-state functional connectivity before and after a course of ECT at the whole-brain and the between- and within-network levels in 17 patients with a depressive episode. Using a group-independent component analysis approach, we focused on four networks known to be affected in depression: the salience network (SN), the default mode network (DMN), the cognitive executive network (CEN), and a subcortical network (SCN). Our clinical measures included mood, cognition, and psychomotor symptoms.
We found ECT to have increased the connectivity of the left CEN with the left angular gyrus and left middle frontal gyrus as well as its within-network connectivity. Both the right CEN and the SCN showed increased connectivity with the precuneus and the anterior DMN with the left amygdala. Finally, improvement of psychomotor retardation was positively correlated with an increase of within-posterior DMN connectivity.
The limitations of our study include its small sample size and the lack of a control dataset to confirm our findings.
Our voxelwise data demonstrate that ECT induces a significant increase of connectivity across the whole brain and at the within-network level. Furthermore, we provide the first evidence on the association between an increase of within-posterior DMN connectivity and an improvement of psychomotor retardation, a core symptom of depression.
电抽搐治疗（ECT）是一种治疗抑郁症的有效方法，但它如何达到临床效果尚不清楚。
我们从大规模脑网络的角度研究了大脑对 ECT 的反应。使用体素分析，我们在 17 名抑郁症患者进行 ECT 疗程前后，在全脑和网络间及网络内水平上，观察了静息状态功能连接。使用组独立成分分析方法，我们关注了四个已知在抑郁症中受影响的网络：突显网络（SN）、默认模式网络（DMN）、认知执行网络（CEN）和皮质下网络（SCN）。我们的临床测量包括情绪、认知和精神运动症状。
我们发现 ECT 增加了左侧 CEN 与左侧角回和左侧额中回的连接以及其网络内连接。右侧 CEN 和 SCN 与楔前叶和前 DMN 与左侧杏仁核的连接都增加了。最后，精神运动迟滞的改善与后 DMN 内连接的增加呈正相关。
我们研究的局限性包括样本量小和缺乏控制数据集来确认我们的发现。
我们的体素数据表明，ECT 诱导了整个大脑和网络内水平的连接显著增加。此外，我们提供了关于后 DMN 内连接增加与精神运动迟滞改善之间关联的第一个证据，精神运动迟滞是抑郁症的核心症状。
