Amsterdam University Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands.
Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA.
Brain Stimul. 2022 Sep-Oct;15(5):1065-1072. doi: 10.1016/j.brs.2022.07.053. Epub 2022 Aug 6.
Electroconvulsive therapy (ECT) is an effective treatment for severe depression and induces gray matter (GM) increases in the brain. Small-scale studies suggest that ECT also leads to changes in brain functioning, but findings are inconsistent. In this study, we investigated the influence of ECT on changes in both brain structure and function and their relation to clinical improvement using multicenter neuroimaging data from the Global ECT-MRI Research Collaboration (GEMRIC).
We analyzed T1-weighted structural magnetic resonance imaging (MRI) and functional resting-state MRI data of 88 individuals (49 male) with depressive episodes before and within one week after ECT. We performed voxel-based morphometry on the structural data and calculated fractional amplitudes of low-frequency fluctuations, regional homogeneity, degree centrality, functional connectomics, and hippocampus connectivity for the functional data in both unimodal and multimodal analyses. Longitudinal effects in the ECT group were compared to repeated measures of healthy controls (n = 27).
Wide-spread increases in GM volume were found in patients following ECT. In contrast, no changes in any of the functional measures were observed, and there were no significant differences in structural or functional changes between ECT responders and non-responders. Multimodal analysis revealed that volume increases in the striatum, supplementary motor area and fusiform gyrus were associated with local changes in brain function.
These results confirm wide-spread increases in GM volume, but suggest that this is not accompanied by functional changes or associated with clinical response. Instead, focal changes in brain function appear related to individual differences in brain volume increases.
电痉挛疗法（ECT）是一种治疗严重抑郁症的有效方法，可引起大脑灰质（GM）增加。小规模研究表明，ECT 还会导致大脑功能发生变化，但研究结果不一致。在这项研究中，我们使用来自全球 ECT-MRI 研究协作组织（GEMRIC）的多中心神经影像学数据，研究了 ECT 对大脑结构和功能变化的影响及其与临床改善的关系。
我们分析了 88 名有抑郁发作的个体（49 名男性）在 ECT 前后一周内的 T1 加权结构磁共振成像（MRI）和功能静息态 MRI 数据。我们对结构数据进行基于体素的形态测量，并在单模态和多模态分析中计算低频波动、区域同质性、度中心性、功能连接组学和海马连接的分数幅度。将 ECT 组的纵向效应与健康对照组（n=27）的重复测量进行比较。
患者在 ECT 后发现 GM 体积广泛增加。相比之下，没有观察到任何功能测量的变化，而且 ECT 反应者和非反应者之间的结构或功能变化没有显著差异。多模态分析显示，纹状体、辅助运动区和梭状回的体积增加与局部脑功能变化相关。
这些结果证实了 GM 体积的广泛增加，但表明这并不伴有功能变化或与临床反应相关。相反，大脑功能的局部变化似乎与大脑体积增加的个体差异有关。
