Electroconvulsive Therapy-Induced Brain Structural and Functional Changes in Major Depressive Disorders: A Longitudinal Study

Abstract

BackgroundThis study aimed to study the brain structural and functional changes after 8 courses of electroconvulsive therapy (ECT) on patients with major depressive disorder (MDD).Material/MethodsMRI scans were performed on 12 depressive patients before and after 8 courses of ECT and compared with those of 15 normal controls. Data were analyzed by voxel-based morphometry (VBM) using SPM8 software. Functional MRI (fMRI) and regional homogeneity (ReHo) analyses were used to assess the functional changes after ECT.ResultsGrey matter volumes were smaller in the right cingulate gyrus of depressive patients before ECT compared with normal controls. After false discovery rate (FDR) correction, post-ECT grey matter volumes were increased in bilateral amygdala and hippocampus compared with pre-ECT. Resting-state ReHo maps showed significant differences in brain activity pre- and post-ECT. Compared with healthy controls, MDD patients treated with 8 courses of ECT showed higher ReHo values in the bilateral frontal lobe, bilateral parietal lobe, and right caudate nucleus. Decreased ReHo values were observed in the right medial temporal gyrus, right superior temporal gyrus, right cingulate gyrus, and left anterior cerebellar lobe.ConclusionsResults suggested that there were both structural and functional differences between the brains of MDD patients and healthy controls. After ECT, both structural and functional changes occurred, but without complete recovery to normal. ECT may display effects through regulating other brain regions to compensate for the original defects.

Electroconvulsive Therapy Induces Cortical Morphological Alterations in Major Depressive Disorder Revealed with Surface-Based Morphometry Analysis

“…[66][67][68] Similar to our results, the regional homogeneity in the left MTG was reported to be increased after eight course of ECT in MDD patients. 13 These results collectively suggested that the structure and function of the left MTG might be associated with the mechanism of ECT in MDD. Although previous studies suggested that the LGI plays an important role in MDD patients, [69][70][71][72] this was the first study using LGI to directly demonstrate the cortical alterations induced by ECT in MDD patients.…”

“…To investigate the brain structural changes induced by ECT in MDD patients, a number of studies were performed using voxel-based morphometry (VBM), reporting changes in gray matter volume in various brain regions, such as the hippocampus, [10][11][12] amygdala, [13][14][15] and temporal lobe. 16,17 However, a recent study using VBM did not identify changes in gray matter volumes in MDD patients after ECT even though the clinical symptoms were significantly improved.…”

Effect of electroconvulsive therapy on hippocampal and amygdala volumes: systematic review and meta-analysis

“…A total of 18 studies met the inclusion criteria for our systematic-review (online Table DS1). 12,18,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] A total of 193 participants from eight independent studies were selected for the meta-analysis. Of these, five independent studies (n = 100) reported volume changes in amygdala.…”

Electroconvulsive therapy modulates functional interactions between submodules of the emotion regulation network in major depressive disorder

“…Previous fMRI studies on ECT response in the MDD patients were mostly based on the whole brain analysis and/or the special regions of interest 22,[43][44][45][46] , whereas few studies were performed at the brain network level 23,47 . However, the pathophysiology of MDD related to the emotion regulation is widely conceptualized as a "systems-level" disorder affecting multiple brain areas [17][18][19]48 .…”