Subramanian Subha, Labonte Alyssa K, Nguyen Thomas, Luong Anhthi H, Hyche Orlandrea, Smith S Kendall, Hogan R Edward, Farber Nuri B, Palanca Ben Julian A, Kafashan MohammadMehdi
Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, United States.
Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Boston, MA, United States.
Front Psychiatry. 2022 Nov 3;13:996733. doi: 10.3389/fpsyt.2022.996733. eCollection 2022.
Electroconvulsive therapy (ECT) is an effective intervention for patients with major depressive disorder (MDD). Despite longstanding use, the underlying mechanisms of ECT are unknown, and there are no objective prognostic biomarkers that are routinely used for ECT response. Two electroencephalographic (EEG) markers, sleep slow waves and sleep spindles, could address these needs. Both sleep microstructure EEG markers are associated with synaptic plasticity, implicated in memory consolidation, and have reduced expression in depressed individuals. We hypothesize that ECT alleviates depression through enhanced expression of sleep slow waves and sleep spindles, thereby facilitating synaptic reconfiguration in pathologic neural circuits.
Correlating ECT Response to EEG Markers (CET-REM) is a single-center, prospective, observational investigation. Wireless wearable headbands with dry EEG electrodes will be utilized for at-home unattended sleep studies to allow calculation of quantitative measures of sleep slow waves (EEG SWA, 0.5-4 Hz power) and sleep spindles (density in number/minute). High-density EEG data will be acquired during ECT to quantify seizure markers.
This innovative study focuses on the longitudinal relationships of sleep microstructure and ECT seizure markers over the treatment course. We anticipate that the results from this study will improve our understanding of ECT.
电休克疗法（ECT）是治疗重度抑郁症（MDD）患者的一种有效干预措施。尽管ECT已长期应用，但其潜在机制尚不清楚，且目前尚无用于常规预测ECT疗效的客观生物标志物。两种脑电图（EEG）标志物，即睡眠慢波和睡眠纺锤波，可能满足这些需求。这两种睡眠微结构EEG标志物均与突触可塑性相关，而突触可塑性与记忆巩固有关，且在抑郁症患者中表达降低。我们假设ECT通过增强睡眠慢波和睡眠纺锤波的表达来缓解抑郁，从而促进病理性神经回路中的突触重构。
ECT反应与EEG标志物相关性研究（CET-REM）是一项单中心、前瞻性观察性研究。带有干式EEG电极的无线可穿戴头带将用于在家中无人值守的睡眠研究，以计算睡眠慢波（EEG慢波活动，0.5-4Hz功率）和睡眠纺锤波（数量/分钟密度）的定量指标。在ECT期间将采集高密度EEG数据以量化癫痫发作标志物。
这项创新性研究关注治疗过程中睡眠微结构与ECT癫痫发作标志物之间的纵向关系。我们预计该研究结果将增进我们对ECT的理解。
