Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Department of Psychiatry, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Psychiatry Res Neuroimaging. 2024 Jan;337:111765. doi: 10.1016/j.pscychresns.2023.111765. Epub 2023 Dec 12.
Depressive rumination has been implicated in the onset, duration, and treatment response of refractory depression. Electroconvulsive therapy (ECT) is remarkably effective in treatment of refractory depression by modulating the functional coordination between brain hubs. However, the mechanisms by which ECT regulates depressive rumination remain unsolved. We investigated degree centrality (DC) in 32 pre- and post-ECT depression patients as well as 38 matched healthy controls. An identified brain region was defined as the seed to calculate functional connectivity (FC) in whole brains. Rumination was measured by the Ruminative Response Scale (RRS) and its relationships with identified DC and FC alterations were examined. We found a significant negative correlation between DC of the right orbitofrontal cortex (rOFC) before ECT and brooding level before and after treatment. Moreover, rOFC DC increased after ECT. DC of the left superior temporal gyrus (lSTG) was positively correlated with reflective level before intervention, while lSTG DC decreased after ECT. Patients showed elevated FC in the rOFC with default mode network. No significant association was found between decreased RRS scores and changes in DC and FC. Our findings suggest that functional changes in rOFC and lSTG may be associated with the beneficial effects of ECT on depressive rumination.
抑郁反刍与难治性抑郁症的发作、持续时间和治疗反应有关。电休克疗法（ECT）通过调节大脑枢纽之间的功能协调性，对难治性抑郁症的治疗具有显著疗效。然而，ECT 调节抑郁反刍的机制仍未解决。我们研究了 32 名ECT 治疗前后的抑郁症患者和 38 名匹配的健康对照者的脑区度中心度（degree centrality，DC）。以一个确定的脑区作为种子，计算全脑的功能连接（functional connectivity，FC）。采用反刍反应量表（Ruminative Response Scale，RRS）评估反刍程度，并探讨了与识别出的 DC 和 FC 变化的关系。我们发现，ECT 前右侧眶额皮质（orbitofrontal cortex，OFC）的 DC 与治疗前后的沉思水平呈显著负相关。此外，ECT 后 rOFC 的 DC 增加。左颞上回（superior temporal gyrus，STG）的 DC 与干预前的反省水平呈正相关，而 ECT 后 lSTG 的 DC 下降。患者的 rOFC 与默认模式网络的 FC 升高。RRS 评分的降低与 DC 和 FC 的变化之间没有显著关联。我们的研究结果表明，rOFC 和 lSTG 的功能变化可能与 ECT 对抑郁反刍的有益作用有关。
