ECT Neuroimaging in Depression: New Review From China

 Out on PubMed, from researchers in China, is this review:

Current progress in neuroimaging research for the treatment of major depression with electroconvulsive therapy.

Li XK, Qiu HT.World J Psychiatry. 2022 Jan 19;12(1):128-139. doi: 10.5498/wjp.v12.i1.128. eCollection 2022 Jan 19.PMID: 35111584 
The abstract is copied below:


Electroconvulsive therapy (ECT) uses a certain amount of electric current to pass through the head of the patient, causing convulsions throughout the body, to relieve the symptoms of the disease and achieve the purpose of treatment. ECT can effectively improve the clinical symptoms of patients with major depression, but its therapeutic mechanism is still unclear. With the rapid development of neuroimaging technology, it is necessary to explore the neurobiological mechanism of major depression from the aspects of brain structure, brain function and brain metabolism, and to find that ECT can improve the brain function, metabolism and even brain structure of patients to a certain extent. Currently, an increasing number of neuroimaging studies adopt various neuroimaging techniques including functional magnetic resonance imaging (MRI), positron emission tomography, magnetic resonance spectroscopy, structural MRI, and diffusion tensor imaging to reveal the neural effects of ECT. This article reviews the recent progress in neuroimaging research on ECT for major depression. The results suggest that the neurobiological mechanism of ECT may be to modulate the functional activity and connectivity or neural structural plasticity in specific brain regions to the normal level, to achieve the therapeutic effect.

Keywords: Electroconvulsive therapy; Magnetic resonance imaging; Magnetic resonance spectroscopy; Major depression; Neuroimaging; Positron emission tomography.

The link to the article is here.


This is a pretty good review of the main neuroimaging methods to investigate the mechanism of action of ECT. There are a few wonky linguistic problems (e.g.,"Despite these shortcomings, it is not possible to fully understand how ECT works,..."), but a good effort overall. 
The above table makes me want to construct an answer to the oft-asked question, "Do doctors even know how ECT works?"
So here goes: 
"ECT normalizes regional brain gray matter volume, improves functional connectivity and white matter integrity, and regulates dopamine, serotonin and glucose metabolism."
Do you think that is better than "The mechanism of action of ECT is unknown"?

And this publication offers an opportunity to distinguish between the journal World Psychiatry (of the WPA, impact factor: 49.5) and the World Journal of Psychiatry (where this article is published, impact factor 3.5).

Scholars/students of the ECT neuroimaging literature will want to read this article in full, ~25 minutes.







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