Decreased Regional Brain Metabolism After ECT

Nobler, Mitchell S.; Oquendo, María A.; Kegeles, Lawrence S.; Malone, Kevin; Campbell, Carl E.; Sackeïm, Harold A.; Mann, J. John

doi:10.1176/appi.ajp.158.2.305

Cited by 291 publications

(151 citation statements)

References 71 publications

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“…SgAcc was found to be overactive in acute sadness and in treatment-resistant depressed patients (Mayberg et al, 1999(Mayberg et al, , 2005. Moreover, antidepressant therapeutic effects in MDD have been linked to SgAcc activity, i.e., mainly a decrease of activity after pharmacological antidepressant treatments Davidson et al, 2003;Walsh et al, 2007), after electroconvulsive therapy (Nobler et al, 2001), or during deep brain stimulation (Mayberg et al, 2005). Moreover, predictive measures of response to cognitive behavior therapy were also found to be linked to activation levels in this brain area (Siegle et al, 2006;Kennedy et al, 2007).…”

Section: Load-related Reduction Of Subgenual Cingulate Activitymentioning

confidence: 99%

Abnormal Neural Filtering of Irrelevant Visual Information in Depression

Desseilles¹,

Balteau²,

Sterpenich³

et al. 2009

J. Neurosci.

108

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The pathophysiology of major depressive disorder (MDD) includes both affective and cognitive dysfunctions. We aimed to clarify how regions regulating affective processing interact with those involved in attention, and how such interaction impacts perceptual processing within sensory cortices. Based on previous work showing that top-down influences from attention can determine the processing of external inputs within early sensory cortices, we tested with functional magnetic resonance imaging (fMRI) whether MDD alters attentional ("top-down") effects on the neural filtering of irrelevant, nonemotional visual stimuli. The present fMRI study was conducted in 14 nonmedicated patients with a first episode of unipolar MDD and 14 matched controls. During scanning, subjects performed two tasks imposing two different levels of attentional load at fixation (easy or difficult), while irrelevant colored stimuli were presented in the periphery. Analyses of fMRI data revealed that MDD patients show (1) an abnormal filtering of irrelevant information in visual cortex, (2) an altered functional connectivity between frontoparietal networks and visual cortices, and (3) a hyperactivity in subgenual cingulate/ medial orbitofrontal cortex that was modulated by attentional load. These results demonstrate that biological abnormalities contribute to the cognitive deficits seen in major depression, and clarify how neural networks implicated in mood regulation influence executive control and perceptual processes. These findings not only improve our understanding of the pathophysiological mechanisms underlying cognitive dysfunctions in MDD, but also shed new light on the interaction between cognition and mood regulation.

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Section: Load-related Reduction Of Subgenual Cingulate Activitymentioning

confidence: 99%

Abnormal Neural Filtering of Irrelevant Visual Information in Depression

Desseilles¹,

Balteau²,

Sterpenich³

et al. 2009

J. Neurosci.

108

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“…112 For electroconvulsive therapy (ECT), the most effective acute depression treatment to date, good clinical response is associated with electrode placement over the PFC 113 and with relatively decreased activity after treatment in the PFC, anterior cingulate, and temporal and parietal cortices. 39,114 Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), two forms of psychotherapy studied for efficacy in the treatment of depression, have effects on affective circuitry that are distinct from those of antidepressant medication. 37,115,116 A "top-down" mechanism has been postulated in which these therapies may enhance function of the orbital cortex/anterior insula and other cortical regions to more effectively attenuate dysregulated limbic activity.…”

Section: Presumptive Mood Disorder Circuitsmentioning

confidence: 99%

Neural circuitry and neuroplasticity in mood disorders: Insights for novel therapeutic targets

Carlson¹,

Singh²,

Zarate³

et al. 2006

NeuroRX

131

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Summary:Major depressive disorder and bipolar disorder are severe mood disorders that affect the lives and functioning of millions each year. The majority of previous neurobiological research and standard pharmacotherapy regimens have approached these illnesses as purely neurochemical disorders, with particular focus on the monoaminergic neurotransmitter systems. Not altogether surprisingly, these treatments are inadequate for many individuals afflicted with these devastating illnesses. Recent advances in functional brain imaging have identified critical neural circuits involving the amygdala and other limbic structures, prefrontal cortical regions, thalamus, and basal ganglia that modulate emotional behavior and are disturbed in primary and secondary mood disorders. Growing evidence suggests that mechanisms of neural plasticity and cellular resilience, including impairments of neurotrophic signaling cascades as well as altered glutamatergic and glucocorticoid signaling, underlie the dysregulation in these circuits. The increasing ability to monitor and modulate activity in these circuits is beginning to yield greater insight into the neurobiological basis of mood disorders. Modulation of dysregulated activity in these affective circuits via pharmacological agents that enhance neuronal resilience and plasticity, and possibly via emerging nonpharmacologic, circuitry-based modalities (for example, deep brain stimulation, magnetic stimulation, or vagus nerve stimulation) offers promising targets for novel experimental therapeutics in the treatment of mood disorders.

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“…Neuroimaging studies of rCBF and rCMR are helpful in addressing mechanisms of therapeutic effects. We have reported that reductions in rCBF in prefrontal regions are associated with positive response to ECT [1], and that a course of bilateral ECT is associated with marked reduction in prefrontal rCMR [2]. We now report on a new study of patients receiving ECT for MDD.…”

Section: Introductionmentioning

confidence: 87%