Department of Magnetic Resonance Imaging, The Second Affiliated Hospital of Xinxiang Medical University, Henan, China.
Mental Hospital, Xinxiang Key Laboratory of Multimodal Brain Imaging, Xinxiang Mental Image Engineering Technology Research Center, Xinxiang, China.
BMC Psychiatry. 2024 Nov 30;24(1):862. doi: 10.1186/s12888-024-06331-9.
Studies have confirmed brain network topology disruption in schizophrenia (SZ). Electroconvulsive therapy (ECT) rapidly improves acute psychiatric symptoms, yet the exact mechanism by which it impacts brain network topology in SZ patients remains unclear. This study aims to explore topological changes in SZ patients' whole-brain functional networks during ECT, ultimately elucidating implicated neurological mechanisms.
This study collected resting-state functional magnetic resonance imaging (rs-fMRI) data from 53 patients with schizophrenia before and after ECT, as well as data from 46 age-, gender-, and education-matched healthy control participants (HC). Using the Brainnetome Atlas, brain functional networks were constructed for each participant. Graph theory methods were applied to measure global and nodal topological properties. Clinical symptoms of patients were assessed using the Positive And Negative Syndrome Scale (PANSS). Independent sample t-tests were employed to compare topological properties between patients and healthy controls, while paired t-tests were used to assess before and after ECT differences within the patient group. Finally, partial correlation analyses were conducted to examine the relationship between changes in topological properties and changes in PANSS scores among patients before and after ECT.
Before ECT, compared to the HC group, the patient group demonstrated reduced local efficiency (Eloc) and clustering coefficient (Cp). In the right superior temporal gyrus, degree centrality (Dc) and nodal global efficiency (Ne) were lower, whereas in the left cingulate gyrus, Ne and Dc were higher. Following ECT, Eloc and Cp normalized in the patient group. Additionally, nodal local efficiency (NLe) and nodal clustering coefficient (NCp) increased in the bilateral superior frontal gyrus. Conversely, in the left inferior parietal lobule, Ne and Dc decreased, and nodal shortest path length (NLp) increased. Both NLe and NCp were lower in the bilateral lateral occipital cortex, both before and after ECT. However, no significant correlation was observed between changes in PANSS scores and alterations in global and nodal topological properties before and after ECT treatment.
Our study suggests that ECT may improve psychiatric symptoms by modulating the integration and dissociation functions within damaged brain networks in SZ patients. Specifically, the balance between the integration and dissociation functions of the default mode network (DMN), central executive network (CEN), and auditory networks (AN) may play a crucial role in the improvement of psychiatric symptoms.
研究已经证实精神分裂症（SZ）患者的大脑网络拓扑结构受到破坏。电抽搐治疗（ECT）可迅速改善急性精神症状，但 ECT 影响 SZ 患者大脑网络拓扑结构的确切机制仍不清楚。本研究旨在探讨 ECT 期间 SZ 患者全脑功能网络的拓扑结构变化，最终阐明涉及的神经机制。
本研究收集了 53 例接受 ECT 前后的精神分裂症患者和 46 例年龄、性别和教育程度匹配的健康对照者（HC）的静息态功能磁共振成像（rs-fMRI）数据。使用脑网络图谱构建每个参与者的脑功能网络。应用图论方法测量全局和节点拓扑属性。使用阳性和阴性综合征量表（PANSS）评估患者的临床症状。采用独立样本 t 检验比较患者与健康对照组之间的拓扑属性，采用配对 t 检验比较患者组 ECT 前后的差异。最后，进行偏相关分析，以检验 ECT 前后患者拓扑属性变化与 PANSS 评分变化之间的关系。
ECT 前，与 HC 组相比，患者组的局部效率（Eloc）和聚类系数（Cp）降低。在右侧颞上回，度中心度（Dc）和节点全局效率（Ne）降低，而在左侧扣带回，Ne 和 Dc 升高。ECT 后，患者组的 Eloc 和 Cp 恢复正常。此外，双侧额上回节点局部效率（NLe）和节点聚类系数（NCp）增加。相反，在左侧顶下小叶，Ne 和 Dc 降低，节点最短路径长度（NLp）增加。双侧外侧枕叶皮质的 NLe 和 NCp 均降低，ECT 前后均如此。然而，ECT 前后治疗前后，PANSS 评分变化与全局和节点拓扑属性变化之间没有观察到显著相关性。
本研究表明，ECT 通过调节 SZ 患者受损脑网络的整合和分离功能，可能改善精神症状。具体来说，默认模式网络（DMN）、中央执行网络（CEN）和听觉网络（AN）的整合和分离功能之间的平衡可能在改善精神症状方面发挥关键作用。
