ALFF Changes and ECT: New Study From China

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

Changes in the amplitude of low-frequency fluctuations in specific frequency bands in major depressive disorder after electroconvulsive therapy.

Li XK, Qiu HT, Hu J, Luo QH.World J Psychiatry. 2022 May 19;12(5):708-721. doi: 10.5498/wjp.v12.i5.708. eCollection 2022 May 19.PMID: 35663299 
The abstract is copied below:

Background: Major depressive disorder (MDD) tends to have a high incidence and high suicide risk. Electroconvulsive therapy (ECT) is currently a relatively effective treatment for MDD. However, the mechanism of efficacy of ECT is still unclear.

Aim: To investigate the changes in the amplitude of low-frequency fluctuations in specific frequency bands in patients with MDD after ECT.

Methods: Twenty-two MDD patients and fifteen healthy controls (HCs) were recruited to this study. MDD patients received 8 ECT sessions with bitemporal placement. Resting-state functional magnetic resonance imaging was adopted to examine regional cerebellar blood flow in both the MDD patients and HCs. The MDD patients were scanned twice (before the first ECT session and after the eighth ECT session) to acquire data. Then, the amplitude of low-frequency fluctuations (ALFF) was computed to characterize the intrinsic neural oscillations in different bands (typical frequency, slow-5, and slow-4 bands).

Results: Compared to before ECT (pre-ECT), we found that MDD patients after the eighth ECT (post-ECT) session had a higher ALFF in the typical band in the right middle frontal gyrus, posterior cingulate, right supramarginal gyrus, left superior frontal gyrus, and left angular gyrus. There was a lower ALFF in the right superior temporal gyrus. Compared to pre-ECT values, the ALFF in the slow-5 band was significantly increased in the right limbic lobe, cerebellum posterior lobe, right middle orbitofrontal gyrus, and frontal lobe in post-ECT patients, whereas the ALFF in the slow-5 band in the left sublobar region, right angular gyrus, and right frontal lobe was lower. In contrast, significantly higher ALFF in the slow-4 band was observed in the frontal lobe, superior frontal gyrus, parietal lobe, right inferior parietal lobule, and left angular gyrus.

Conclusion: Our results suggest that the abnormal ALFF in pre- and post-ECT MDD patients may be associated with specific frequency bands.

Keywords: Amplitude of low-frequency fluctuations; Electroconvulsive therapy; Major depressive disorder; Resting-state functional magnetic resonance imaging; Specific frequency bands.


The article is available here.

10.5498/wjp.v12.i5.708

Li XK, Qiu HT, Hu J, Luo QH. Changes in the amplitude of low-frequency fluctuations in specific frequency bands in major depressive disorder after electroconvulsive therapy. World J Psychiatry 2022; 12(5): 708-721 [PMID: 35663299 DOI: 10.5498/wjp.v12.i5.708]










This is a sophisticated yet boring paper. The images are pretty and the findings suggestive of traceable brain changes with ECT. But it smacks of the "least publishable unit" syndrome; and without replication, it is just one more fMRI study of questionable significance. 
Maybe this is just the "good" boring of incremental scientific discovery, akin to the good boring of psychotherapy and anesthesia. 
A full read for aficionados of the ECT neuroimaging literature will be ~ 25 minutes, and please, if you think this is an important finding, feel free to comment, thanks.

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