Wang Xing-Yu, Tan Huan, Li Xiao, Dai Lin-Qi, Zhang Zhi-Wei, Lv Fa-Jin, Yu Ren-Qiang
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Psychiatry. 2022 Jul 25;13:972968. doi: 10.3389/fpsyt.2022.972968. eCollection 2022.
While electroconvulsive therapy (ECT) has been repeatedly been shown to effectively and efficiently treat the major depressive disorder (MDD), the mechanistic basis for such therapeutic efficacy remains to be firmly established. As such, further research exploring the ECT-based treatment of MDD in an adolescent population is warranted.
This study included 30 treatment-naïve first-episode MDD patients and 30 healthy control (HC) individuals (aged 12-17 years). All participants were scanned using rs-fMRI, and the 30 MDD patients were scanned again after 2 weeks of the ECT treatment period. Intrinsic local activity in each voxel was assessed based on the fractional amplitude of low frequency fluctuation (fALFF) parameter, with all fALFF analyses being completed using the REST application. Correlations between ECT-related changes in fALFF and clinical parameters were additionally examined.
Relative to HCs, MDD patients exhibited increased fALFF values in the right inferior frontal gyrus (ORBinf), inferior occipital gyrus (IOG), and the left middle frontal gyrus (MFG) at baseline. Following ECT, these patients exhibited significant increases in fALFF values in the right medial superior frontal gyrus (SFGmed), dorsolateral superior frontal gyrus (SFGdor), anterior cingulate, and paracingulate gyrus (ACG), median cingulate and paracingulate gyrus (DCG), and left MFG. MDD patient HAMD scores were negatively correlated with fALFF values when analyzing pre-ECT vs. post-HCT ΔHAMD and fALFF values in the right SFGmed, SFGdor, and the left MFG.
These data suggest that ECT induced altered fALFF in some regions of the brain, suggesting that these alterations may serve as a neurobiological indicator of ECT effectiveness in MDD adolescents.
虽然反复研究表明电休克疗法（ECT）能有效治疗重度抑郁症（MDD），但其治疗效果的机制基础仍有待明确。因此，有必要进一步研究ECT在青少年群体中治疗MDD的情况。
本研究纳入30例未接受过治疗的首发MDD患者和30名健康对照（HC）个体（年龄在12 - 17岁）。所有参与者均接受静息态功能磁共振成像（rs - fMRI）扫描，30例MDD患者在ECT治疗2周后再次进行扫描。基于低频振幅分数（fALFF）参数评估每个体素的内在局部活动，所有fALFF分析均使用REST软件完成。此外，还检查了ECT相关的fALFF变化与临床参数之间的相关性。
与HC相比，MDD患者在基线时右侧额下回（ORBinf）、枕下回（IOG）和左侧额中回（MFG）的fALFF值升高。ECT治疗后，这些患者右侧额上回内侧（SFGmed）、额上回背外侧（SFGdor）、前扣带回和旁扣带回（ACG）、中央扣带回和旁扣带回（DCG）以及左侧MFG的fALFF值显著增加。在分析ECT前与ECT后汉密尔顿抑郁量表（HAMD）评分差值（ΔHAMD）以及右侧SFGmed、SFGdor和左侧MFG的fALFF值时，MDD患者的HAMD评分与fALFF值呈负相关。
这些数据表明ECT可引起大脑某些区域的fALFF改变，提示这些改变可能是ECT治疗青少年MDD有效性的神经生物学指标。
