Zhong Yi, Li Jianfeng, Li Haitao, Li Mingzhe, Lyu Yanaohai, Cui Minghu, Gao Yujun
Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430000, Hubei, China.
Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China.
Depress Anxiety. 2024 Feb 12;2024:9211145. doi: 10.1155/2024/9211145. eCollection 2024.
It is a high risk for adolescents with first-episode major depressive disorder (MDD) to commit suicide. However, few studies reported the effect of modified electroconvulsive therapy (MECT) in first-episode antipsychotic-naive MDD adolescents.
The study explores the alternations of regional homogeneity of modified electroconvulsive therapy to treat the first-episode antipsychotic-naive major depressive disorder. 72 first-episode MDD patients were recruited from Tianyou Hospital Affiliated to Wuhan University of Science and Technology from October 2017 to May 2020, and 65 of 72 completed the trial.
Before MECT treatment, ReHo values of the bilateral cerebellum and left cuneus were higher, and ReHo value of left postcentral and supramarginal gyrus was lower in MDD patients compared to healthy subjects (HS). After treatment, the MDD patients have higher ReHo values of the right insula and postcentral gyrus, while left fusiform gyrus were lower than the pretreatment. Compared to the HS, the ReHo values of left lingual gyrus, right calcarine cortex, and right mid occipital thalamus were higher in the posttreatment. In the posttreatment, left calcarine cortex and right cerebrum were lower than in healthy subjects.
The study confirmed that MECT improves psychotic symptoms in patients with first-episode antipsychotic-naive MDD. These results further contributed to a more tailored treatment approach to MDD from the pathophysiological and neuroimaging views.
首发重度抑郁症（MDD）青少年自杀风险很高。然而，很少有研究报道改良电休克治疗（MECT）对首发未使用过抗精神病药物的MDD青少年的疗效。
本研究探讨改良电休克治疗首发未使用过抗精神病药物的重度抑郁症时局部一致性的变化。2017年10月至2020年5月，从武汉科技大学附属天佑医院招募了72例首发MDD患者，72例中有65例完成了试验。
与健康受试者（HS）相比，MDD患者在MECT治疗前双侧小脑和左侧楔叶的局部一致性值较高，而左侧中央后回和缘上回的局部一致性值较低。治疗后，MDD患者右侧岛叶和中央后回的局部一致性值较高，而左侧梭状回低于治疗前。与HS相比，治疗后左侧舌回、右侧距状皮质和右侧枕中丘脑的局部一致性值较高。治疗后，左侧距状皮质和右侧大脑低于健康受试者。
该研究证实MECT可改善首发未使用过抗精神病药物的MDD患者的精神病症状。这些结果从病理生理学和神经影像学角度进一步推动了针对MDD的更具针对性的治疗方法。
