Diffision Kurtosis Imaging: New ECT Study From China

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

A novel approach to investigate the mechanism of electroconvulsive therapy in the treatment of major depression disorder: Diffusion kurtosis imaging.

Yang J, Tong P, Dong LP, Shi YH.J Psychiatr Res. 2024 Sep 24;179:372-378. doi: 10.1016/j.jpsychires.2024.09.036. Online ahead of print.PMID: 39368399

The abstract is copied below:



Background: Major depression disorder (MDD) exhibits a high global incidence; however, its pathogenesis remains elusive. In this prospective study, we employed diffusion kurtosis imaging (DKI) to investigate changes in brain function among patients with MDD both pre- and post-electroconvulsive therapy (ECT).

Methods: We divided a sample of 22 MDD patients into ECT group, which received six treatments over a span of two weeks, and control group (n = 12). DKI scanning was performed before and after treatment. The Hamilton Depression Rating Scale (HAMD) and Life Satisfaction Rating Scale (LSRS) were administered to assess depressive symptoms at baseline, on the 14th day, and at month three.

Results: Significant differences were found between group, time and time × group in terms of HAMD score and LSRS score. In the ECT group compared to pre- ECT measurement, changes in mean diffusivity (MD), fractional Anisotropy (FA), mean kurtosis (MK), radial kurtosis (RK), FA of kurtosis (KA), and anxia kurtosis (AK) value were detected in specific regions such as the frontal, temporal lobe, and hippocampus. In the control group only MD and RK value increased in a limited number of area.

Conclusions: ECT holds the potential to elicit neuroplasticity in the brain, facilitating rapid structural modifications and amelioration of depressive symptoms in patients with MDD.

Keywords: Diffusion kurtosis imaging; Electroconvulsive therapy; Hamilton depression rating scale; Magnetic resonance imaging; Major depression disorder.


From the text:









Call me a Luddite if you will, but I had never heard of "kurtosis." It's a real thing in statistics/mathematics (has to do with "tailedness" and outliers), but whether it has anything relevant to offer re clinical neuroimaging in psychiatry is another matter...

But here it is. Perhaps it is related to our recent discussion of MRI "texture"?
Okay then, ECT leads to microstructural changes in the brain. Let's see this replicated and then have a serious discussion about its significance.



Comments

Post a Comment

Popular posts from this blog

ECT plus Antidepressants: a Review

Out on PubMed, from researchers in Rotterdam, The Netherlands, is this review: Influence of an adjuvant antidepressant on the efficacy of  electroconvulsive  therapy: A systematic review and meta-analysis. Pluijms EM, Kamperman AM, Hoogendijk WJ, Birkenhäger TK, van den Broek WW. Aust N Z J Psychiatry. 2020 Sep 8:4867420952543. doi: 10.1177/0004867420952543. Online ahead of print. PMID:  32900217 Here is the "Conclusion" section from the text: Our results suggest that an adjuvant antidepressant enhances the efficacy of ECT in patients with major depression. Although the included studies had some methodological limitations, effect sizes were consistently small to moderate. We speculate that modern-day controlled trials using adequately dosed TCAs and MAOIs will most likely result in larger effect sizes. From a clinical point of view, we prefer an adjuvant TCA to an adjuvant MAOI, since TCAs are generally safe to use with ECT ( American Psychiatric Association, 2001 ; ...
Read more

Clinical Phenotype of Behavioral-Variant Frontotemporal Dementia Reversed by ECT: A Case Report

Image
Out on PubMed, from authors in Germany, is this case report and literature review: Clinical Phenotype of Behavioral-Variant Frontotemporal Dementia Reversed by  ECT : A Case Report. Breitling B, Bartels C, Lange C, Bouter C, Falk HS, Wiltfang J, Zilles-Wegner D, Besse M. Neuropsychobiology. 2024 Dec 2:1-12. doi: 10.1159/000541668. Online ahead of print. PMID:  39622206 The abstract is copied below: Introduction: Diagnosis of frontotemporal dementia (FTD) remains difficult even in the presence of core clinical and imaging features. Furthermore, disease-modifying treatments are lacking. Case presentation: Here, we report a case of a patient with clinical and imaging features of FTD. Electroconvulsive therapy (ECT) was used to target affective and catatonic symptoms. After ECT, the patient showed improvements not only in affective symptoms but also in cognitive domains, leading to a marked improvement in the patient's level of functioning. Conclusion: Against the background of di...
Read more

Early Use of the Name "ECT"- Sacklers in 1949

Image
 "Classics in ECT" brings you this study from Creedmore State Hospital in 1949: Nonconvulsive biochemotherapy with histamine and electric convulsive therapy; a comparative study on hospitalized psychotics with a control  ECT  series. SACKLER AM, SACKLER MD, SACKLER RR. J Nerv Ment Dis. 1949 Sep;110(3):185-97. doi: 10.1097/00005053-194911030-00001. PMID:  18138865 The pdf is here . I originally choose this article as the earliest in PubMed to use the name, "ECT," although it also uses "electric [sic] convulsive therapy."  The very first PubMed "ECT" citation is from 1947, but it is written "E.C.T." and also reports a complication, so we prefer this one. Nomenclature aside, this turns out to be an interesting read, with what would now be considered a somewhat bizarre study comparing histamine therapy with ECT. Among the interesting details are the inclusion of a couple of patients with postpartum psychosis and the observation that longer ...
Read more