Brain functional effects of electroconvulsive therapy during emotional processing in major depressive disorder
Brain functional effects of electroconvulsive therapy during emotional processing in major depressive disorder
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DOI：
10.1016/j.brs.2020.03.018
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发表时间：
2020-07-01
影响因子：
7.7
通讯作者：
Redlich, Ronny
中科院分区：
文献类型：
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作者：
Enneking, Verena;Dzvonyar, Fanni;Redlich, Ronny
背景：在难治性抑郁症（MDD）中，电休克治疗（ECT）是一种高效的治疗方法。虽然ECT对脑结构的影响越来越多，但ECT对情绪处理过程中脑功能的影响还很不清楚。目的：研究ECT对负性情绪刺激处理过程中前扣带皮层（ACC）和杏仁核活性的影响及其与临床反应的关系。在这项非随机纵向研究中，对MDD患者（n = 37）在ECT治疗前后进行了评估。健康对照组（n = 37）的年龄和性别相匹配。功能性磁共振成像（fMRI）获得两次，在基线和六周后使用阈上面部匹配范例。为了评估临床反应的影响，额外的事后分析进行比较应答者nonresponders.Results：ECT后，MDD患者表现出统计学显着增加ACC活性在处理过程中的负面情绪刺激（P（FWE）= 0.039）。该效应由应答者驱动（p（FWE）= 0.023），而无应答者未显示增加。与非应答者相比，应答者的治疗前ACC活性也较低（p（FWE）= 0.025）。在杏仁核中没有显着的影响可以observed.Conclusions：ECT导致大脑功能的变化，在ACC，相关区域的情绪调节过程中的负面刺激。此外，基线ACC活性可作为治疗反应的生物标志物。研究结果与最近的研究一致，这些研究强调了预处理ACC与一般抗抑郁治疗反应相关的特性。(C)2020作者（S）爱思唯尔公司出版
Background: In treatment-resistant major depressive disorder (MDD), electroconvulsive therapy (ECT) is a treatment with high efficacy. While knowledge regarding changes in brain structure following ECT is growing, the effects of ECT on brain function during emotional processing are largely unknown.Objective: We investigated the effects of ECT on the activity of the anterior cingulate cortex (ACC) and amygdala during negative emotional stimuli processing and its association with clinical response.Methods: In this non-randomized longitudinal study, patients with MDD (n = 37) were assessed before and after treatment with ECT. Healthy controls (n = 37) were matched regarding age and gender. Functional magnetic resonance imaging (fMRI) was obtained twice, at baseline and after six weeks using a supraliminal face-matching paradigm. In order to evaluate effects of clinical response, additional post-hoc analyses were performed comparing responders to non-responders.Results: After ECT, patients with MDD showed a statistically significant increase in ACC activity during processing of negative emotional stimuli (p(FWE) = .039). This effect was driven by responders (p(FWE) = .023), while non-responders showed no increase. Responders also had lower pre-treatment ACC activity compared to non-responders (p(FWE) = .025). No significant effects in the amygdala could be observed.Conclusions: ECT leads to brain functional changes in the ACC, a relevant region for emotional regulation during processing of negative stimuli. Furthermore, baseline ACC activity might serve as a biomarker for treatment response. Findings are in accordance with recent studies highlighting properties of pretreatment ACC to be associated with general antidepressive treatment response. (C) 2020 The Author(s). Published by Elsevier Inc.