Functional Connectivity Study in ECT from China

Out on PubMed is this study from Hefei, China:

Bifrontal electroconvulsive therapy changed regional homogeneity and functional connectivity of left angular gyrus in major depressive disorder.

Mo Y, Wei Q, Bai T, Zhang T, Lv H, Zhang L, Ji G, Yu F, Tian Y, Wang K.Psychiatry Res. 2020 Sep 20;294:113461. doi: 10.1016/j.psychres.2020.113461. Online ahead of print.PMID: 33038791
The abstract is copied below:

Electroconvulsive therapy (ECT) is a rapid and effective treatment for MDD. However, the mechanism of ECT for MDD has not been clarified. In this study, we used resting-state functional magnetic resonance imaging (rs-fMRI) to explore the mechanism of ECT. Two groups of subjects were recruited: healthy controls (HCs) and MDD patients who received bifrontal ECT. MDD patients and HCs underwent rs-fMRI scans and clinical assessments (Hamilton Depression Rating Scale, Rey-Auditory Verbal Learning Test (RAVLT), and the verbal fluency test). Regional homogeneity (ReHo) and functional connectivity were evaluated for the analysis of rs-fMRI data. The results showed that ReHo values in the left angular gyrus (LAG) significantly increased in MDD patients after ECT, and the functional connectivity of the LAG with bilateral inferior temporal gyrus, bilateral middle frontal gyrus, left superior frontal gyrus, left middle temporal gyrus, left precuneus, left posterior cingulate gyrus, and right angular gyrus was found to be strengthened after ECT. The scores of delayed recall trial in the RAVLT of MDD patients were related to the functional connectivity of the LAG with the left inferior temporal gyrus and the left posterior cingulate gyrus. It indicated LAG palyed an important role in the mechanism of ECT in MDD.

Keywords: Angular gyrus; Electroconvulsive therapy; Functional connectivity; Major depressive disorder; Regional homogeneity; Resting-state functional magnetic resonance imaging; Rey-Auditory Verbal Learning Test.

The pdf is here.

This is yet another small (n= 28 depressed patients) fMRI study with a possibly interesting finding.  Confirmation of whether or not the left angular gyrus truly has a role in depressive pathology and the mechanism of action of ECT will need to await replication of this study. The correlation of cognitive effects with these regional brain changes also remains speculative without replication.

The ECT schedule used in this study was interesting: ECT on 3 consecutive days, then 3X/week. Dosing was age based, so this was relatively high dose bifrontal ECT.


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