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Effects of Electroconvulsive Therapy on Brain Functional Activation and Connectivity in Depression.
MedLine Citation:
PMID:  22820953     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Past neuroimaging work has suggested that increased activation to cognitive and emotional tasks and decreased connectivity in frontal regions are related to cognitive inefficiency in depression; normalization of these relationships has been associated with successful treatment. The present study investigated brain function before and after electroconvulsive therapy (ECT) in patients with major depressive disorder (MDD) and demonstrated the effect of treatment on cortical activation patterns. METHODS: Six ECT-naive patients with depression (mean ± SD age, 39.0 ± 5.4 years) were treated with ECT. Within 1 week before and 1 to 3 weeks after ECT, the patients underwent a magnetic resonance imaging session with functional magnetic resonance image scanning during working memory and affective tasks and during rest. Changes in voxelwise statistical maps of brain response to each task in regions identified to be relevant from past studies of depression were compared with changes in depression severity as measured by the Hamilton Depression Rating Score. Changes in functional connectivity between brain regions were also compared with changes in depression severity. RESULTS: Activation during both tasks was generally found to be decreased after ECT. Remission of depression was significantly associated with reduced affective deactivation after ECT in the orbitofrontal cortex (P = 0.03). Whole-brain functional connectivity of the anterior cingulate cortex showed a consistent increase in connectivity to the right dorsolateral prefrontal cortex and posterior cingulate cortex after ECT. CONCLUSIONS: These results suggest that successful ECT for MDD is associated with decreased activation to cognitive and emotional tasks and an increase in resting connectivity.
Authors:
Erik B Beall; Donald A Malone; Roman M Dale; David J Muzina; Katherine A Koenig; Pallab K Bhattacharrya; Stephen E Jones; Michael D Phillips; Mark J Lowe
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-19
Journal Detail:
Title:  The journal of ECT     Volume:  -     ISSN:  1533-4112     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9808943     Medline TA:  J ECT     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the *Imaging Institute, and †Neurological Institute, Cleveland Clinic, Cleveland, OH; and ‡Neurosciences Therapeutic Resource Center, Medco Health Solutions, Inc, Fort Worth, TX.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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