Modulation of Intrinsic Brain Activity by Electroconvulsive Therapy in Major Depression

Leaver, Amber M.; Espinoza, Randall; Pirnia, Tara; Joshi, Shantanu H.; Woods, Roger P.; Narr, Katherine L.

doi:10.1016/j.bpsc.2015.09.001

Cited by 53 publications

(58 citation statements)

References 65 publications

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“…Our study adds that increased pulvinar BOLD-signal at baseline was reduced after treatment. Thalamocortical coupling is altered in depression and antidepressant therapy targets this connection [26][27][28]. HC healthy control subjects, rMD remitted depressed subjects, aMD acute depressed patients fMRI-1 functional magnetic resonance imaging session one, HAM-D 24 Hamilton Depression Rrating Scale (24 item version), HAM-A Hamilton Anxiety Rating Scale, BDI Beck Depression Index, CGI Clinical Global Impression scale, f female, m male, y years, m months, r right, l left a p-value chi-square test b p-value analysis of variance c p-value t-test d for detiailed medication see supplementary Table S5 e only one patient Antidepressant effects on the pulvinar and the thalamus are substantiated in other fMRI tasks [29][30][31].…”

Section: Discussionmentioning

confidence: 99%

The pulvinar nucleus and antidepressant treatment: dynamic modeling of antidepressant response and remission with ultra-high field functional MRI

et al. 2018

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Functional magnetic resonance imaging (fMRI) successfully disentangled neuronal pathophysiology of major depression (MD), but only a few fMRI studies have investigated correlates and predictors of remission. Moreover, most studies have used clinical outcome parameters from two time points, which do not optimally depict differential response times. Therefore, we aimed to detect neuronal correlates of response and remission in an antidepressant treatment study with 7 T fMRI, potentially harnessing advances in detection power and spatial specificity. Moreover, we modeled outcome parameters from multiple study visits during a 12-week antidepressant fMRI study in 26 acute (aMD) patients compared to 36 stable remitted (rMD) patients and 33 healthy control subjects (HC). During an electrical painful stimulation task, significantly higher baseline activity in aMD compared to HC and rMD in the medial thalamic nuclei of the pulvinar was detected (p = 0.004, FWE-corrected), which was reduced by treatment. Moreover, clinical response followed a sigmoid function with a plateau phase in the beginning, a rapid decline and a further plateau at treatment end. By modeling the dynamic speed of response with fMRI-data, perigenual anterior cingulate activity after treatment was significantly associated with antidepressant response (p < 0.001, FWE-corrected). Temporoparietal junction (TPJ) baseline activity significantly predicted non-remission after 2 antidepressant trials (p = 0.005, FWE-corrected). The results underline the importance of the medial thalamus, attention networks in MD and antidepressant treatment. Moreover, by using a sigmoid model, this study provides a novel method to analyze the dynamic nature of response and remission for future trials.

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Section: Discussionmentioning

confidence: 99%

The pulvinar nucleus and antidepressant treatment: dynamic modeling of antidepressant response and remission with ultra-high field functional MRI

et al. 2018

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“…However, several of these neuroplastic changes do not significantly relate to changes of clinical response. Specifically, in our prior studies, changes in hippocampal and ACC morphometry and functional connectivity between the dorsal ACC, mediodorsal thalamus, hippocampus, right anterior temporal, medial parietal, and posterior cingulate cortex show moderate relationships with ECT symptom improvements (51, 52, 54). It is thus plausible that changes in particular structural and functional networks may relate to changes in cognitive function occurring with ECT that are at least partially independent of changes in network activity relating to clinical outcome.…”

Section: Discussionmentioning

confidence: 76%

Short- and Long-term Cognitive Outcomes in Patients With Major Depression Treated With Electroconvulsive Therapy

Vasavada

Leaver

Njau

et al. 2017

J ECT

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Objectives The risk of cognitive impairment is a concern for patients with major depressive disorder (MDD) receiving electroconvulsive therapy (ECT). Here, we evaluate the acute, short-term and long-term effects of ECT on tests of processing speed, executive function, memory, and attention. Methods Forty-four MDD patients receiving ECT (61% right unilateral (RUL), 39% mixed RUL-bitemporal, left UL and/or bitemporal lead placement underwent a cognitive battery prior to ECT (T1), after 2 sessions (T2), and at the end of the index (T3). Thirty-two patients returned for a 6-month follow-up (T4). Thirty-three controls were assessed at two times ~4 weeks apart (C1 and C2). Results At baseline, patients showed deficits in processing speed, executive function and memory compared to controls. Including depression severity and lead placement covariates, linear mixed model analysis showed significant improvement in only processing speed between T1 and T3 and between T1 and T4 in patients. An acute decline in attention and verbal memory was observed at T2, but performance returned to baseline levels at T3. Longitudinal cognitive outcomes did not differ in patients defined as ECT responders/non-responders. Limitations Episodic memory was not measured and medications were not controlled between T3 and T4. Controls also showed improvements in processing speed, suggesting practice effects for some measures. Conclusions In this naturalistic ECT treatment study, results show that the initiation of ECT may transiently affect memory and executive function, but cognition is largely unaffected during and post ECT. While some functions might improve, others will at least remain stable up to 6-months following the ECT index.

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“…Not surprisingly, given its importance to developmental psychopathology, connectivity of the ACC has been implicated in each of these research directions for depression (e.g. Barrett et al, 2004; Leaver et al, 2016; Spati et al, 2015). Research in this field could also, ultimately, identify new brain targets for intervention.…”

Section: Discussionmentioning

confidence: 99%

Adolescent brain development and depression: A case for the importance of connectivity of the anterior cingulate cortex

Lichenstein

Verstynen

Forbes

2016

Neuroscience & Biobehavioral Reviews

104

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We propose that structural and functional connectivity of the anterior cingulate cortex (ACC) represents a critical component of adolescent developmental psychopathology. We hypothesize that connectivity of the ACC, a hub for integrating cognitive, affective, and social information to guide self-regulation across domains, supports adaptive development of self-regulation during adolescence and that, conversely, disrupted maturation of ACC connectivity contributes to the development of depression. To integrate findings on typical development, we report results of a meta-analysis of diffusion imaging findings of typical adolescent development of the cingulum and anterior thalamic radiation, the tracts most relevant to ACC connectivity, and provide a critical review of the literature on ACC functional connectivity. Finally, we review the evidence for altered structural and functional connectivity in adolescents with depression. Although the evidence for our claim is persuasive, a more comprehensive understanding of the ACC’s role depends upon future investigations with sophisticated modeling of networks, prospective and longitudinal designs, and examination of structure-function associations.

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Modulation of Intrinsic Brain Activity by Electroconvulsive Therapy in Major Depression

Cited by 53 publications

References 65 publications

The pulvinar nucleus and antidepressant treatment: dynamic modeling of antidepressant response and remission with ultra-high field functional MRI

The pulvinar nucleus and antidepressant treatment: dynamic modeling of antidepressant response and remission with ultra-high field functional MRI

Short- and Long-term Cognitive Outcomes in Patients With Major Depression Treated With Electroconvulsive Therapy

Adolescent brain development and depression: A case for the importance of connectivity of the anterior cingulate cortex

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