Disruptions of Brain Networks and Sleep by Electroconvulsive Therapy

摘要 电休克治疗（ECT）是治疗精神疾病患者的有效干预措施。 具体来说，它是一种针对缺乏以下症状的难治性抑郁症（TRD）患者的既定治疗方法： 对至少两种抗抑郁药物的反应。尽管有高达70%的疗效， 关于ECT减轻精神症状或发挥认知功能的回路水平机制， 损伤ECT诱导全身性癫痫发作并引起功能网络内的神经可塑性变化。一 更好地了解ECT是迫切需要的，因为它是一个重复的程序下进行的一般 麻醉及其益处受到治疗后认知障碍的限制。脑电图 (EEG)能够捕捉大脑活动的时间动态，在不同的唤醒状态和最近 高密度EEG技术的发展允许阐明大规模的功能性脑网络。 在睡眠期间记录EEG可以提供有关睡眠结构的见解。在这项研究中，“大脑网络的中断 和睡眠电休克治疗，”我们将调查的影响，电休克对信息传输效率 在与睡眠慢波相关的功能网络中，这是突触可塑性的EEG标记。这件事的新奇之处在于 这项建议源于我们对睡眠、觉醒和睡眠期间EEG标记物纵向评估的关注。 治疗过程中ECT诱导的癫痫发作。我们还将获得抑郁症严重程度的结果， 记忆是纵向测量的。无线可穿戴设备将解决以前的纵向障碍 门诊ECT环境中睡眠微结构的研究。基于图的高密度脑电信号网络分析 信号允许表征功能网络上的信息传输。这些信息措施是 在特定的子网络中进行局部研究，并在大规模功能网络中进行全局研究。纵向 在整个ECT过程中对EEG的评估以及临床和认知结果将提供一个 独特的机会，以提高我们的电路机制的发展背后的理解， 认知障碍和抗抑郁作用。此外，我们的发现可能会揭示 其他针对精神疾病患者睡眠慢波活动的非侵入性干预措施。 总的来说，阐明ECT对不同唤醒状态下信息处理的影响可能具有 通过鉴定潜在的新生物标志物和治疗靶点， to the improvement改善of public公共health健康for TRD患者.

ABSTRACT Electroconvulsive therapy (ECT) is an effective intervention for treating patients with psychiatric disorders. Specifically, it is an established treatment for patients with Treatment-Resistant Depression (TRD) with a lack of responsiveness to at least two pharmacologic antidepressants. Despite an efficacy of up to 70%, little is known about the circuit-level mechanisms through which ECT alleviates psychiatric symptoms or exerts cognitive impairments. ECT induces generalized seizures and causes neuroplastic changes within functional networks. A better understanding of ECT is urgently needed given that it is a repetitive procedure performed under general anesthesia and its benefits are limited by cognitive impairment following treatment. Electroencephalography (EEG) enables capturing the temporal dynamics of brain activity in different states of arousal and recent developments in high-density EEG technology allow for elucidation of large-scale functional brain networks. Recording EEG during sleep provides insights about sleep structure. In this study, “Disruptions of Brain networks and Sleep by Electroconvulsive Therapy,” we will investigate the impact of ECT on information transfer efficiency in functional networks in relation to sleep slow waves, an EEG marker of synaptic plasticity. The novelty of this proposal stems from our focus on the longitudinal assessment of EEG markers during sleep, wakefulness, and ECT-induced seizures over the course of therapy. We will also acquire depression severity outcomes and memory measures longitudinally. Wireless wearable devices will address previous barriers to the longitudinal study of sleep microstructure in the outpatient ECT settings. Graph-based network analyses of high-density EEG signals allow characterization of information transfer over functional networks. These information measures are investigated locally in specific subnetworks and globally over large-scale functional networks. Longitudinal assessments of EEG throughout the course of ECT alongside clinical and cognitive outcomes will provide a unique opportunity to improve our understanding of the circuit mechanisms underlying the development of cognitive impairments and antidepressant effects incurred during ECT. Furthermore, our findings may shed light on other non-invasive interventions targeting sleep slow wave activity in patients with psychiatric illnesses. Overall, elucidating the impact of ECT on information processing in different states of arousal may have promising clinical implications through identification of potential new biomarkers and therapeutic targets leading to the improvement of public health for TRD patients.