Structural network changes in patients with major depression and schizophrenia treated with electroconvulsive therapy
Structural network changes in patients with major depression and schizophrenia treated with electroconvulsive therapy
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DOI：
10.1016/j.euroneuro.2016.06.008
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发表时间：
2016-09-01
影响因子：
5.6
通讯作者：
Thomann, Philipp Arthur
中科院分区：
文献类型：
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作者：
Wolf, Robert Christian;Nolte, Henrike Maria;Thomann, Philipp Arthur
电休克治疗（ECT）是治疗难治性重度抑郁症（MDD）最有效的方法之一。在精神分裂症（SZ）中，ECT通常被认为是耐药病例，作为抗精神病药物治疗的增强或在需要快速症状缓解的病例中。越来越多的神经影像学证据表明，ECT对MDD患者的内侧颞叶和前额叶皮质区域有调制作用。在SZ，ECT对脑结构的影响尚未进行系统的研究。在这项研究中，我们调查了21例接受右侧单侧ECT的ECT初治患者（12例MDD，9例SZ）的脑容量。包括21名健康对照。在ECT前后采集结构磁共振成像数据。健康的参与者被扫描一次。基于源的形态计量学被用来调查调制的结构网络前/后ECT。ECT对MDD和SZ中不同的结构网络产生了影响。在MDD和SZ中，SBM均显示内侧颞叶（MTL）网络（包括海马和海马旁皮质），ECT后该网络显着增加。MTL网络强度的增加与MDD或SZ的临床改善无关。在SZ中，ECT后外侧前额叶/扣带回皮质网络体积增加，这种效应伴随着临床改善。这些研究结果提供了初步的证据，结构网络的变化，以ECT在MDD和SZ。这些数据表明，诊断特异性和跨诊断ECT对脑容量的影响。与SZ相反，在MDD中，ECT对结构网络的调节与临床改善无关。(C)2016 Elsevier B. V.和ECNR保留所有权利。
Electroconvulsive therapy (ECT) is one of the most effective treatments in severe and treatment-resistant major depressive disorder (MDD). In schizophrenia (SZ), ECT is frequently considered in drug-resistant cases, as an augmehtation of antipsychotic treatment or in cases when rapid symptom relief is indicated. Accumulating neuroimaging evidence suggests modulation of medial temporal lobe and prefrontal cortical regions in MDD by ECT. In SZ, ECT-effects on brain structure have not been systematically investigated so far. In this study, we investigated brain volume in 21 ECT-naive patients (12 with MDD, 9 with SZ) who received right sided unilateral ECT. Twenty-one healthy controls were included. Structural magnetic resonance imaging data were acquired before and after ECT. Healthy participants were scanned once. Source-based morphometry was used to investigate modulation of structural networks pre/post ECT. ECT had an impact on distinct structural networks in MDD and SZ. In both MDD and SZ SBM revealed a medial temporal lobe (MTL) network (including hippocannpus and parahippocampal cortex) which showed a significant increase after ECT. The increase in MTL network strength was not associated with clinical improvement in either MDD or SZ. In SZ a Lateral prefrontal/cingulate cortical network showed a volume increase after ECT, and this effect was accompanied by clinical improvement. These findings provide preliminary evidence for structural network change in response to ECT in MDD and SZ. The data suggest both diagnosis-specific and transdiagnostic ECT-effects on brain volume. In contrast to SZ, in MDD structural network modulation by ECT was not associated with clinical improvement. (C) 2016 Elsevier B.V. and ECNR All rights reserved.