A positron emission tomography study of the serotonin1B receptor effect of electroconvulsive therapy for severe major depressive episodes
A positron emission tomography study of the serotonin1B receptor effect of electroconvulsive therapy for severe major depressive episodes
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DOI：
10.1016/j.jad.2021.07.060
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发表时间：
2021-07-29
影响因子：
6.6
通讯作者：
Okubo，Yoshiro
中科院分区：
文献类型：
--
作者：
Tiger，Mikael;Garde，Martin;Okubo，Yoshiro
背景：电休克治疗(ECT)是一种治疗抑郁症的有效方法，但其分子作用机制尚不清楚。5-羟色胺1B(5-HT1B)受体是治疗抑郁症的潜在靶点，前人在抑郁症的正电子发射断层扫描(PET)研究中已报道边缘区域5-HT1B受体结合率低。方法：这项纵向PET研究的目的是观察ECT对抑郁症5-HT1B受体结合的影响。对15例有严重抑郁发作的住院患者进行正电子发射计算机断层扫描(PET)和5-HT1B受体选择性放射配基[11C]AZ10419369检查。15名年龄和性别匹配的对照组接受了检查。选择先前报道的抑郁症患者5-HT1B受体结合率低的边缘区域和背侧脑干区。结果：13例患者按方案完成研究。13名患者中有11名对ECT有反应。电刺激后大鼠海马区5-HT1B受体结合量增加30%(p=0.021)。使用线性混合效应模型，我们观察到ECT后5-HT1B受体结合量增加，效应大小为中到大，不同地区之间没有显著差异。在探索性分析中，观察到ECT治疗后5-HT1B受体结合的变化与汉密尔顿抑郁评定量表中激越评分之间的强相关性。限制：尽管这是一项具有代表性的PET研究，但样本量仍然很小，并且存在潜在的药物混杂效应。结论：ECT治疗抑郁症后观察到5-HT1B受体结合增加，与先前发现的快速作用氯胺酮治疗难治性抑郁症后海马区5-HT1B受体结合增加的结果相一致。
Background: Electroconvulsive therapy (ECT) is an effective treatment for depressive disorders, although its molecular mechanism of action is unknown. The serotonin 1B (5-HT1B) receptor is a potential target for treatment of depression and low 5-HT1Breceptor binding in limbic regions has been reported in previous positron emission tomography (PET) studies of depression.Methods: The objective of this longitudinal PET study was to examine the effect of ECT for depression on 5-HT1Breceptor binding. Fifteen hospitalized patients with major depressive episodes were examined with PET and the 5-HT1Breceptor selective radioligand [11C]AZ10419369, before and after ECT. Fifteen controls matched for age and sex were examined. Limbic regions with previously reported low 5-HT1Breceptor binding in depression and a dorsal brain stem region were selected.Results: Thirteen patients completed the study according to protocol. Eleven out of thirteen patients responded to ECT. 5-HT1Breceptor binding in hippocampus increased with 30 % after ECT (p=0.021). Using linear mixed effects modelling, we observed increases in 5-HT1Breceptor binding following ECT with a moderate to large effect size, which did not differ significantly between regions. In an exploratory analysis, strong correlations between changes in 5-HT1Breceptor binding and agitation scores on the Hamilton Depression Rating Scale after ECT were observed.Limitations: Albeit representative of a PET study, the sample size is still small and there are potential confounding effects of medication.Conclusions: Increased 5-HT1Breceptor binding was observed following ECT for depression, corresponding to previous findings of increased 5-HT1Breceptor binding in hippocampus after rapid acting ketamine for treatment resistant depression.