Multi-modal imaging investigation of electroconvulsive therapy response in depre

抑郁症电休克治疗反应的多模态成像研究

• 批准号: 9108403
• 负责人: Christopher C Abbott
• 金额: $ 27.51万
• 依托单位: THE MIND RESEARCH NETWORK
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9108403
• 关键词: Academic Medical Centers; Affect; Anticonvulsants; Biological Markers; Brain; Centers of Research Excellence; Clinical; Cognition; Data; Depressive disorder; Development; Diagnostic; Electroconvulsive Therapy; Frequencies; Functional Magnetic Resonance Imaging; Functional disorder; Gold; Image; Investigation; Link; Measures; Mental Depression; Methods; Modality; Multimodal Imaging; Neurobiology; Neurotransmitters; Patients; Pharmacological Treatment; Physiologic pulse; Placebos; Property; Protocols documentation; Protons; Psychiatry; Recording of previous events; Research; Resistance; Rest; Seizures; Series; Spectrum Analysis; Stimulus; Symptoms; Therapeutic; Therapeutic Intervention; Urban Hospitals; Width; case control; cingulate gyrus; depressed patient; depressive symptoms; effective therapy; functional disability; gamma-Aminobutyric Acid; grasp; imaging biomarker; improved; independent component analysis; longitudinal design; neural correlate; neuropsychiatric disorder; neuropsychological; neuroregulation; response; standard care; success; suicidal; treatment responders; treatment-resistant depression

Electroconvulsive therapy (ECT) remains the gold-standard treatment for severe, treatment-resistant patients with depressive episodes. During a typical 4-week ECT series, most depressive episodes remit, and formerly suicidal or psychotically depressed patients will resume their premorbid levels of functioning. ECT is one of psychiatry's most invasive treatments and remains limited to academic medical centers or larger, metropolitan hospitals. Despite ECT's 80-year history, the lack of understanding regarding the neurobiology and the mechanism of action of ECT response limit the development of safer, more accessible treatments. The overall aim of this investigation is to identify the biomarkers of ECT response. A case-control longitudinal design and resting state functional magnetic resonance imaging (fMRI) will simultaneously assess between (Aim 1) and within network changes (Aim 2) associated with ECT response. Our preliminary data supports our hypothesis that ECT response increases between network relationships amid frontal and default mode networks and reduces within network low frequency power (0.01 to 0.1 hertz (Hz)) in the subcallosal cingulate gyrus. The ECT series is associated with increased seizure threshold and reduced seizure duration. These anticonvulsant properties of ECT may be related to the reduction in spectral power within functional networks. In Aim 3, proton spectroscopy (H-MRS) will measure changes in concentrations of gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter, associated with ECT response. The multi-modal aspect of this investigation will link changes in GABA concentrations with changes in the fMRI biomarkers of ECT response (Aims 1 and 2). Specifically, we hypothesize that increased GABA concentrations in the posterior cingulate will correlate with reduced low frequency spectral power (0.01 and 0.1 Hz) within limbic and para-limbic networks. This research will impact the field with a better understanding of the functional neural correlates of ECT response, which will help to optimize ECT treatment parameters (e.g., pulse width, stimulus delivery method, number of treatments) and extend to other therapeutic interventions for treatment-resistant depression.

电休克疗法(ECT)仍然是治疗严重、耐药的黄金标准疗法。 有抑郁发作的患者。在一个典型的为期四周的ECT系列赛中，大多数抑郁发作会缓解，并且 以前有自杀倾向或精神抑郁的患者将恢复患病前的功能水平。ECT是 精神病学最具侵入性的治疗之一，目前仍仅限于学术医疗中心或更大的大都市 医院。尽管ECT已有80年的历史，但对神经生物学和 ECT反应的作用机制限制了更安全、更容易获得的治疗方法的发展。这个 这项研究的总体目标是确定ECT反应的生物标志物。病例对照纵向设计 而静息状态的功能磁共振成像(FMRI)将同时评估(AIM) 1)和与ECT响应相关联的网络变化(目标2)。我们的初步数据支持我们的假设 前端和默认模式网络之间的网络关系之间的ECT响应增加 并减少网络内的低频功率(0.01至0.1赫兹(赫兹))，在扣带回。 ECT序列与癫痫阈值升高和癫痫发作持续时间缩短有关。这些 ECT的抗惊厥作用可能与功能网络中光谱功率的降低有关。 在目标3中，质子光谱学(H-MRS)将测量伽马-氨基丁酸浓度的变化 (GABA)，主要的抑制性神经递质，与ECT反应有关。它的多模式方面 研究将把GABA浓度的变化与ECT反应的fMRI生物标记物的变化联系起来 (目标1和2)。具体地说，我们假设后扣带回GABA浓度的增加将 与边缘和边缘旁网络内降低的低频频谱功率(0.01和0.1赫兹)相关。 这项研究将对ECT的功能神经关联有更好的理解，从而对该领域产生影响 响应，这将有助于优化ECT治疗参数(例如，脉冲宽度，刺激传递方法， 治疗次数)，并延伸到其他治疗难治性抑郁症的干预措施。