title: Effects of electroconvulsive therapy on amygdala function in major depression - a longitudinal functional magnetic resonance imaging study.
abstract: BACKGROUND
  Electroconvulsive therapy (ECT) is one of the most effective treatments for severe depression. However, little is known regarding brain functional processes mediating ECT effects.
  
  
  METHODS
  In a non-randomized prospective study, functional magnetic resonance imaging data during the automatic processing of subliminally presented emotional faces were obtained twice, about 6 weeks apart, in patients with major depressive disorder (MDD) before and after treatment with ECT (ECT, n = 24). Additionally, a control sample of MDD patients treated solely with pharmacotherapy (MED, n = 23) and a healthy control sample (HC, n = 22) were obtained.
  
  
  RESULTS
  Before therapy, both patient groups equally showed elevated amygdala reactivity to sad faces compared with HC. After treatment, a decrease in amygdala activity to negative stimuli was discerned in both patient samples indicating a normalization of amygdala function, suggesting mechanisms potentially unspecific for ECT. Moreover, a decrease in amygdala activity to sad faces was associated with symptomatic improvements in the ECT sample (r spearman = -0.48, p = 0.044), and by tendency also for the MED sample (r spearman = -0.38, p = 0.098). However, we did not find any significant association between pre-treatment amygdala function to emotional stimuli and individual symptom improvement, neither for the ECT sample, nor for the MED sample.
  
  
  CONCLUSIONS
  In sum, the present study provides first results regarding functional changes in emotion processing due to ECT treatment using a longitudinal design, thus validating and extending our knowledge gained from previous treatment studies. A limitation was that ECT patients received concurrent medication treatment.
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: R
authors.initials: R
authors.lastname: Redlich
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: C
authors.initials: C
authors.lastname: Bürger
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: K
authors.initials: K
authors.lastname: Dohm
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: D
authors.initials: D
authors.lastname: Grotegerd
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: N
authors.initials: N
authors.lastname: Opel
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: D
authors.initials: D
authors.lastname: Zaremba
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: S
authors.initials: S
authors.lastname: Meinert
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: K
authors.initials: K
authors.lastname: Förster
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: J
authors.initials: J
authors.lastname: Repple
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: R
authors.initials: R
authors.lastname: Schnelle
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: C
authors.initials: C
authors.lastname: Wagenknecht
authors.affiliation: Department of Psychiatry,University of Marburg,Marburg,Germany.
authors.forename: M
authors.initials: M
authors.lastname: Zavorotnyy
authors.affiliation: Department of Clinical Radiology,University of Münster,Münster,Germany.
authors.forename: W
authors.initials: W
authors.lastname: Heindel
authors.affiliation: Department of Clinical Radiology,University of Münster,Münster,Germany.
authors.forename: H
authors.initials: H
authors.lastname: Kugel
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: M
authors.initials: M
authors.lastname: Gerbaulet
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: J
authors.initials: J
authors.lastname: Alferink
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: V
authors.initials: V
authors.lastname: Arolt
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: P
authors.initials: P
authors.lastname: Zwanzger
authors.affiliation: Department of Psychiatry,University of Münster,Münster,Germany.
authors.forename: U
authors.initials: U
authors.lastname: Dannlowski
mesh_terms: D000328:Adult; D000679:Amygdala / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods*; D005149:Facial Expression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies
keywords: Amygdala; depression; electroconvulsive therapy; emotion processing; functional magnetic resonance imaging