Electroconvulsive therapy-induced brain plasticity determines therapeutic outcome in mood disorders
Electroconvulsive therapy-induced brain plasticity determines therapeutic outcome in mood disorders
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DOI：
10.1073/pnas.1321399111
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发表时间：
2014-01-21
影响因子：
11.1
通讯作者：
Draganski, Bogdan
中科院分区：
文献类型：
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作者：
Dukart, Juergen;Regen, Francesca;Draganski, Bogdan
由于电休克治疗(ECT)的非特异性和空间上的无针对性，缺乏关于这种治疗如何起作用的信息和知识，因此在使用ECT治疗精神疾病方面仍然存在许多科学、临床和伦理方面的争议。ECT的作用模式甚至被归因于一种“野蛮”的安慰剂效应。在这里，我们展示了ECT对两个人群的区域脑结构的不同的、高度特异性的、空间分布的影响：单相或双相情感障碍患者。单相和双相障碍对ECT和相关的局部脑体积变化的反应不同，这些变化发生在以前与这些疾病相关的区域，与症状严重程度和治疗效果相关。我们独特的证据表明，电物理治疗效应，虽然普遍应用，但通过与大脑病理生理学的相互作用而具有区域性意义。
There remains much scientific, clinical, and ethical controversy concerning the use of electroconvulsive therapy (ECT) for psychiatric disorders stemming from a lack of information and knowledge about how such treatment might work, given its nonspecific and spatially unfocused nature. The mode of action of ECT has even been ascribed to a "barbaric" form of placebo effect. Here we show differential, highly specific, spatially distributed effects of ECT on regional brain structure in two populations: patients with unipolar or bipolar disorder. Unipolar and bipolar disorders respond differentially to ECT and the associated local brain-volume changes, which occur in areas previously associated with these diseases, correlate with symptom severity and the therapeutic effect. Our unique evidence shows that electrophysical therapeutic effects, although applied generally, take on regional significance through interactions with brain pathophysiology.