Dai Mengyao, Li Yanzhang, Tian Yanghua
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China.
The College of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230000, China.
Sci Rep. 2025 Jun 4;15(1):19597. doi: 10.1038/s41598-025-04114-0.
Depression is a common mood disorder characterized by persistent sadness, loss of interest or pleasure, and a range of cognitive and physical symptoms such as gastrointestinal dysfunction that significantly impair daily functioning. Electroconvulsive Therapy (ECT) remains the treatment of choice and a critical last-resort intervention for patients with severe, treatment-resistant depression, particularly those at high risk of suicide. Evidence suggests that the gut-brain axis, a complex bidirectional communication network, plays a key role in the development of these multifaceted symptoms. This study explores the possibility that ECT may exert its therapeutic effects by modulating gastrointestinal function. In clinical investigation, a notable proportion of patients with major depressive disorder experienced significant alleviation of gastrointestinal symptoms, particularly constipation, following ECT. In preclinical research, Electroconvulsive Shock (ECS) is commonly applied to animal models as an experimental analogue to explore the mechanisms and efficacy of ECT. Complementary experiments in mice revealed that daily ECS not only reversed depressive-like behaviors but also restored colonic motility. This effect was closely associated with the normalization of neural activity in the hypothalamic paraventricular nucleus (PVN), a key brain region involved in autonomic nervous regulation. Importantly, these benefits were abolished by subdiaphragmatic vagotomy, underscoring the pivotal role of the vagus nerve in mediating gut-brain interactions. These findings offer insights into the neural pathways underpinning the gut-brain connection, highlighting the potential of ECT not only as a last line of defense against severe depression but also as a means to address associated gastrointestinal dysfunction.
抑郁症是一种常见的情绪障碍，其特征为持续的悲伤、兴趣或愉悦感丧失，以及一系列认知和身体症状，如胃肠功能障碍，这些症状会严重损害日常功能。电休克疗法（ECT）仍然是重度难治性抑郁症患者的首选治疗方法和关键的最后手段干预措施，尤其是那些有高自杀风险的患者。有证据表明，肠-脑轴作为一个复杂的双向通信网络，在这些多方面症状的发展中起关键作用。本研究探讨了ECT可能通过调节胃肠功能发挥其治疗作用的可能性。在临床研究中，相当一部分重度抑郁症患者在接受ECT治疗后，胃肠症状，尤其是便秘，得到了显著缓解。在临床前研究中，电休克（ECS）通常被应用于动物模型，作为ECT的实验模拟来探索其机制和疗效。在小鼠身上进行的补充实验表明，每日进行ECS不仅能逆转抑郁样行为，还能恢复结肠蠕动。这种效应与下丘脑室旁核（PVN）神经活动的正常化密切相关，PVN是参与自主神经调节的关键脑区。重要的是，膈下迷走神经切断术消除了这些益处，强调了迷走神经在介导肠-脑相互作用中的关键作用。这些发现为支撑肠-脑连接的神经通路提供了见解，突出了ECT不仅作为重度抑郁症的最后一道防线，而且作为解决相关胃肠功能障碍手段的潜力。
