全脑功能连接动力学与电抽搐治疗反应的关系。
Whole-Brain Functional Connectivity Dynamics Associated With Electroconvulsive Therapy Treatment Response.
机构信息
Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Georgia.
Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Georgia; National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, China.
出版信息
Biol Psychiatry Cogn Neurosci Neuroimaging. 2022 Mar;7(3):312-322. doi: 10.1016/j.bpsc.2021.07.004. Epub 2021 Jul 23.
BACKGROUND
Depressive episodes (DEPs), characterized by abnormalities in cognitive functions and mood, are a leading cause of disability. Electroconvulsive therapy (ECT), which involves a brief electrical stimulation of the anesthetized brain, is one of the most effective treatments used in patients with DEP due to its rapid efficacy.
METHODS
In this work, we investigated how dynamic brain functional connectivity responds to ECT and whether the dynamic responses are associated with treatment outcomes and side effects in patients. We applied a fully automated independent component analysis-based pipeline to 110 patients with DEP (including diagnosis of unipolar depression or bipolar depression) and 60 healthy control subjects. The dynamic functional connectivity was analyzed by a combination of the sliding window approach and clustering analysis.
RESULTS
Five recurring connectivity states were identified, and patients with DEPs had fewer occurrences in one brain state (state 1) with strong positive and negative connectivity. Patients with DEP changed the occupancy of two states (states 3 and 4) after ECT, resulting in significantly different occurrences of one additional state (state 3) compared with healthy control subjects. We further found that patients with DEP had diminished global metastate dynamism, two of which recovered to normal after ECT. The changes in dynamic connectivity characteristics were associated with the changes in memory recall and Hamilton Depression Rating Scale of DEP after ECT.
CONCLUSIONS
These converging results extend current findings on subcortical-cortical dysfunction and dysrhythmia in DEP and demonstrate that ECT might cause remodeling of brain functional dynamics that enhance the neuroplasticity of the diseased brain.
背景
抑郁发作（DEP）以认知功能和情绪异常为特征，是导致残疾的主要原因。电抽搐疗法（ECT）是一种对麻醉大脑进行短暂电刺激的方法，由于其快速疗效，是治疗 DEP 患者的最有效方法之一。
方法
在这项工作中，我们研究了大脑功能连接的动态如何对 ECT 产生反应，以及这种动态反应是否与患者的治疗效果和副作用相关。我们应用了一种基于全自动独立成分分析的流水线，对 110 名 DEP 患者（包括单相或双相抑郁的诊断）和 60 名健康对照进行了分析。通过滑动窗口方法和聚类分析相结合，对动态功能连接进行了分析。
结果
我们发现了五个重复出现的连接状态，而 DEP 患者在一个具有强正、负连接的大脑状态（状态 1）中出现的次数较少。DEP 患者在 ECT 后改变了两个状态（状态 3 和 4）的占有率，导致与健康对照组相比，一个额外状态（状态 3）的出现次数显著不同。我们进一步发现，DEP 患者的全局元状态动态性降低，其中两个在 ECT 后恢复正常。动态连接特征的变化与 ECT 后记忆回忆和 Hamilton 抑郁评定量表的变化有关。
结论
这些一致的结果扩展了当前关于 SUBCOARTAL-CORTICAL 功能障碍和 DEP 节律紊乱的发现，并表明 ECT 可能导致大脑功能动力学的重塑，从而增强患病大脑的神经可塑性。
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