He Kewei, Zhu Tong, Yu Renqiang, Zhang Jingbo, Min Jing, Huang Yang, Mo Xue, Ma Yunfeng, He Xiangqian, Lv Fajin, Zeng Jianguang, Li Chao, McNamara Robert K, Lei Du, Liu Mengqi
College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China.
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
J Affect Disord. 2025 Apr 1;374:495-502. doi: 10.1016/j.jad.2025.01.071. Epub 2025 Jan 15.
Major depressive disorder (MDD) in adolescents is associated with an increased risk of suicide, and electroconvulsive therapy (ECT) is an effective treatment for MDD and suicidal ideation. To investigate underlying central mechanisms, this study examined functional connectome topological organization in adolescents with MDD and suicidal ideation prior to and following ECT.
Resting-state fMRI images were collected from 28 adolescents with MDD and suicidal ideation and 31 demographically similar healthy adolescents. Whole-brain functional networks were constructed and topological metrics were analyzed using graph theory approaches.
Prior to ECT, depressed adolescents showed disrupted global and nodal properties, indicating altered functional connectivity. Following ECT, significant reductions in depression and suicidality symptoms were observed, with a 75 % response rate. ECT led to an increase in the small-worldness of the brain network, suggesting restoration of functional connectivity. Significant improvements were seen in nodal properties, particularly in the central executive network. Group-by-time interactions revealed differences between responders and non-responders in nodal degree and efficiency.
Larger sample sizes and extended followed-up periods following ECT treatment are needed to further investigate the neural basis of clinical changes.
The results of this study reveal dynamic changes in brain network topology of adolescents with depression during the course of ECT, and have an advanced understanding of the neurobiological biomarkers associated with the efficacy of ECT treatment.
青少年重度抑郁症（MDD）与自杀风险增加相关，而电休克疗法（ECT）是治疗MDD和自杀意念的有效方法。为了探究潜在的中枢机制，本研究检测了ECT治疗前后患有MDD和自杀意念的青少年的功能连接组拓扑组织。
收集了28名患有MDD和自杀意念的青少年以及31名人口统计学特征相似的健康青少年的静息态功能磁共振成像（fMRI）图像。构建全脑功能网络，并使用图论方法分析拓扑指标。
在ECT治疗前，抑郁青少年表现出整体和节点属性的破坏，表明功能连接改变。ECT治疗后，观察到抑郁和自杀症状显著减轻，有效率为75%。ECT导致脑网络的小世界特性增加，提示功能连接恢复。节点属性有显著改善，尤其是在中央执行网络。组间时间交互作用揭示了反应者和无反应者在节点度和效率方面的差异。
需要更大的样本量和ECT治疗后的延长随访期来进一步研究临床变化的神经基础。
本研究结果揭示了ECT治疗过程中抑郁青少年脑网络拓扑结构的动态变化，并对与ECT治疗疗效相关的神经生物学生物标志物有了更深入的了解。
