title: Antidepressant Effects of Electroconvulsive Therapy Correlate With Subgenual Anterior Cingulate Activity and Connectivity in Depression.
abstract: The mechanisms underlying the effects of electroconvulsive therapy (ECT) in major depressive disorder (MDD) are not fully understood. Resting-state functional magnetic resonance imaging (rs-fMRI) is a new tool to study the effects of brain stimulation interventions, particularly ECT. The authors aim to investigate the mechanisms of ECT in MDD by rs-fMRI.They used rs-fMRI to measure functional changes in the brain of first-episode, treatment-naive MDD patients (n = 23) immediately before and then following 8 ECT sessions (brief-pulse square-wave apparatus, bitemporal). They also computed voxel-wise amplitude of low-frequency fluctuation (ALFF) as a measure of regional brain activity and selected the left subgenual anterior cingulate cortex (sgACC) to evaluate functional connectivity between the sgACC and other brain regions.Increased regional brain activity measured by ALFF mainly in the left sgACC following ECT. Functional connectivity of the left sgACC increased in the ipsilateral parahippocampal gyrus, pregenual ACC, contralateral middle temporal pole, and orbitofrontal cortex. Importantly, reduction in depressive symptoms were negatively correlated with increased ALFF in the left sgACC and left hippocampus, and with distant functional connectivity between the left sgACC and contralateral middle temporal pole. That is, across subjects, as depression improved, regional brain activity in sgACC and its functional connectivity increased in the brain.Eight ECT sessions in MDD patients modulated activity in the sgACC and its networks. The antidepressant effects of ECT were negatively correlated with sgACC brain activity and connectivity. These findings suggest that sgACC-associated prefrontal-limbic structures are associated with the therapeutic effects of ECT in MDD.
authors.affiliation: From the Department of Radiology (YL, YL); Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China (LD, WZ, DL, JZ, YF, HQ, XL, TQ, HH, HM, QL); Department of Psychiatry Brain Stimulation Laboratory, Medical University of South Carolina, Charleston, SC (LD, XL); and Medical Psychology Department, the Third Military Medical University third hospital, Chongqing, P.R. China (HL).
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.forename: Lian
authors.initials: L
authors.lastname: Du
authors.forename: Yongmei
authors.initials: Y
authors.lastname: Li
authors.forename: Haixia
authors.initials: H
authors.lastname: Liu
authors.forename: Wenjing
authors.initials: W
authors.lastname: Zhao
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.forename: Jinkun
authors.initials: J
authors.lastname: Zeng
authors.forename: Xingbao
authors.initials: X
authors.lastname: Li
authors.forename: Yixiao
authors.initials: Y
authors.lastname: Fu
authors.forename: Haitang
authors.initials: H
authors.lastname: Qiu
authors.forename: Xirong
authors.initials: X
authors.lastname: Li
authors.forename: Tian
authors.initials: T
authors.lastname: Qiu
authors.forename: Hua
authors.initials: H
authors.lastname: Hu
authors.forename: Huaqing
authors.initials: H
authors.lastname: Meng
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Luo
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001921:Brain; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male
chemical_list: D000928:Antidepressive Agents