Electroconvulsive Therapy Induces Cortical Morphological Alterations in Major Depressive Disorder Revealed with Surface-Based Morphometry Analysis

Although electroconvulsive therapy (ECT) is one of the most effective treatments for major depressive disorder (MDD), the mechanism underlying the therapeutic efficacy and side effects of ECT remains poorly understood. Here, we investigated alterations in the cortical morphological measurements including cortical thickness (CT), surface area (SA), and local gyrification index (LGI) in 23 MDD patients before and after ECT. Furthermore, multivariate pattern analysis using linear support vector machine (SVM) was applied to investigate whether the changed morphological measurements can be effective indicators for therapeutic efficacy of ECT. Surface-based morphometry (SBM) analysis found significantly increased vertex-wise and regional cortical thickness (CT) and surface area (SA) in widespread regions, mainly located in the left insula (INS) and left fusiform gyrus, as well as hypergyrification in the left middle temporal gyrus (MTG) in MDD patients after ECT. Partial correlational analyses identified associations between the morphological properties and depressive symptom scores and impaired memory scores. Moreover, SVM result showed that the changed morphological measurements were effective to classify the MDD patients before and after ECT. Our findings suggested that ECT may enhance cortical neuroplasticity to facilitate neurogenesis to remit depressive symptoms and to impair delayed memory. These findings indicated that the cortical morphometry is a good index for therapeutic efficacy of ECT.

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Alterations in patients with major depressive disorder before and after electroconvulsive therapy measured by fractional amplitude of low-frequency fluctuations (fALFF)

Journal of Affective Disorders ◽

10.1016/j.jad.2018.10.099 ◽

2019 ◽

Vol 244 ◽

pp. 92-99 ◽

Cited By ~ 11

Author(s):

Haitang Qiu ◽

Xinke Li ◽

Qinghua Luo ◽

Yongming Li ◽

Xichuan Zhou ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Electroconvulsive Therapy ◽

Low Frequency ◽

Major Depressive ◽

Before And After ◽

Frequency Fluctuations

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Case Report: Changes in Regional Cerebral Blood Flow in Chronic Akathisia of a Depressed Patient Before and After Electroconvulsive Therapy Treatment

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.728265 ◽

2021 ◽

Vol 12 ◽

Author(s):

Akihito Suzuki ◽

Ryota Kobayashi ◽

Toshinori Shirata ◽

Hitomi Komoriya ◽

Masafumi Kanoto ◽

...

Keyword(s):

Blood Flow ◽

Major Depressive Disorder ◽

Cerebral Blood Flow ◽

Depressive Disorder ◽

Electroconvulsive Therapy ◽

Regional Cerebral Blood Flow ◽

Parietal Lobe ◽

Regional Cerebral Blood ◽

Major Depressive ◽

Before And After

Akathisia, which characterized by subjective restlessness and objective hyperactivity, is induced mostly by antipsychotics and antidepressants. Chronic akathisia is defined as persistence of symptoms for more than 3 months. The pathophysiology of chronic akathisia remains unclear. This report describes a depressed patient, a 66-year-old woman with a diagnosis of major depressive disorder, with chronic akathisia. Her regional cerebral blood flow (rCBF) was measured using single photon emission computed tomography (SPECT) before and after the treatment with electroconvulsive therapy (ECT). She had experienced akathisia-like symptoms three times prior because of risperidone, escitalopram, and clomipramine administration, accompanied by major depression. After levomepromazine was added to quetiapine to treat insomnia, she developed akathisia symptoms such as a sense of restlessness and inability to sit in one place for a few minutes. These antipsychotics were withdrawn. Propranolol was administered, leading to no apparent improvement for 8 months. After she was diagnosed as having major depressive disorder and chronic akathisia, she received 10 sessions of bilateral ECT. Her depressive symptoms improved greatly. Akathisia disappeared completely after ECT. SPECT revealed that rCBF was decreased in the middle frontal gyrus and parietal lobe, that it was increased in the thalamus, fusiform gyrus, and cerebellum before ECT, and that these abnormalities in rCBF were approaching normal levels after ECT. Findings presented in this report suggest ECT as a beneficial treatment for chronic akathisia. Altered rCBF in the middle frontal gyrus, parietal lobe, thalamus, fusiform gyrus, and cerebellum, and especially decreased rCBF in the parietal lobe, may be related to the pathophysiology of chronic akathisia.

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Alterations in the Occipital Cortex of Drug-Naïve Adults With Major Depressive Disorder: A Surface-Based Analysis of Surface Area and Cortical Thickness

Psychiatry Investigation ◽

10.30773/pi.2021.0099 ◽

2021 ◽

Vol 18 (10) ◽

pp. 1025-1033

Author(s):

Jee Soo Lee ◽

Wooyoung Kang ◽

Youbin Kang ◽

Aram Kim ◽

Kyu-Man Han ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Surface Area ◽

Cortical Thickness ◽

Occipital Cortex ◽

Major Depressive ◽

Posterior Cingulate ◽

Lingual Gyrus ◽

Drug Naïve ◽

Middle Occipital Gyrus

Objective Advances in surface-based morphometric methods have allowed researchers to separate cortical volume into cortical thickness (CTh) and surface area (SA). Although CTh alterations in major depressive disorder (MDD) have been observed in numerous studies, few studies have described significant SA alterations. Our study aimed to measure patients’ SAs and to compare it with their CTh to examine whether SA exhibits alteration patterns that differ from those of CTh in drug-naïve patients with MDD.Methods A total of 71 drug-naïve MDD patients and 111 healthy controls underwent structural magnetic resonance imaging, and SA and CTh were analyzed between the groups.Results We found a smaller SA in the left superior occipital gyrus (L-SOG) in drug-naïve patients with MDD. In the CTh analysis, the bilateral fusiform gyrus, left middle occipital gyrus, left temporal superior gyrus, and right posterior cingulate showed thinner cortices in patients with MDD, while the CTh of the bilateral SOG, right straight gyrus, right posterior cingulate, and left lingual gyrus were increased.Conclusion Compared with the bilateral occipito-temporal changes in CTh, SA alterations in patients with MDD were confined to the L-SOG. These findings may improve our understanding of the neurobiological mechanisms of SA alteration in relation to MDD.

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Propofol Anaesthesia in Electroconvulsive Therapy

The British Journal of Psychiatry ◽

10.1192/bjp.165.4.506 ◽

1994 ◽

Vol 165 (4) ◽

pp. 506-509 ◽

Cited By ~ 45

Author(s):

Christopher F. Fear ◽

Carl S. Littlejohns ◽

Eryl Rouse ◽

Paul McQuail

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Electroconvulsive Therapy ◽

Rating Scale ◽

Induction Agent ◽

Double Blind Study ◽

Major Depressive ◽

Seizure Duration ◽

Double Blind ◽

Induction Agents

BackgroundThe induction agent propofol is known to reduce electroconvulsive therapy (ECT) seizure duration. It is assumed that outcome from depression is adversely affected by this agent. This study compares propofol and methohexitone as induction agents for ECT.MethodIn a prospective, randomised, double-blind study 20 subjects with major depressive disorder (DSM-III-R criteria) received propofol or methohexitone anaesthesia. The Hamilton Depression Rating Scale and Beck Depression Inventory were used to assess depression before therapy, at every third treatment, and at the end of therapy. Seizure duration was measured using the cuff technique.ResultsMean seizure durations (P < 0.01) and mean total seizure duration (P < 0.01) were shorter in the propofol group. There was no difference in outcome.ConclusionsUse of propofol may not adversely affect outcome from depression and it is not necessarily contraindicated as an induction agent for ECT. Our results should be interpreted cautiously, and larger studies are needed.

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Reduced latency to first antidepressant treatment in Italian patients with a more recent onset of major depressive disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.715 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S529-S529

Author(s):

B. Grancini ◽

B. Dell’Osso ◽

L. Cremaschi ◽

F. De Cagna ◽

B. Benatti ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Antidepressant Treatment ◽

Stressful Events ◽

Major Depressive ◽

Recent Onset ◽

Valid Predictor ◽

Before And After ◽

Competing Interest ◽

Year 2000

IntroductionMajor depressive disorder (MDD) is a prevalent burdensome disease, which frequently remains untreated. The duration of untreated illness (DUI) is modifiable parameter and a valid predictor of outcome. Previous investigation in patients with MDD revealed a DUI of different years, while recent reports have documented a reduction of DUI across time, in patients with different psychiatric disorders.Objectives/aimsThe present study was aimed to investigate potential differences in terms of DUI and related variables in patients with MDD across time.MethodsAn overall sample of 188 patients with MDD was divided in two subgroups on the basis of their epoch of onset (onset before and after year 2000). DUI and other onset-related variables were assessed through a specific questionnaire and compared between the two subgroups.ResultsThe whole sample showed a mean DUI of approximately 4.5 years, with a lower value in patients with more recent onset compared to the other subgroup (27.1 ± 42.6 vs. 75.8 ± 105.2 months, P < .05). Moreover, patients with onset after 2000 reported higher rates of onset-related stressful events and lower ones for benzodiazepines prescription (65% vs. 81%; P = 0.02; 47% vs. 30%; P = 0.02).ConclusionsThe comparison of groups with different epochs of onset showed a significant reduction in terms of DUI and benzodiazepines prescription, and a higher rate of onset-related stressful events in patients with a more recent onset. Reported findings are of epidemiologic and clinical relevance in order to evaluate progress and developments in the diagnostic and therapeutic pathways of MDD in Italian and other countries.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Early improvement as a predictor of final remission in major depressive disorder: New insights in electroconvulsive therapy

Journal of Affective Disorders ◽

10.1016/j.jad.2018.03.014 ◽

2018 ◽

Vol 235 ◽

pp. 169-175 ◽

Cited By ~ 6

Author(s):

Erika Martínez-Amorós ◽

Ximena Goldberg ◽

Verònica Gálvez ◽

Aida de Arriba- Arnau ◽

Virginia Soria ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Electroconvulsive Therapy ◽

Major Depressive ◽

Early Improvement

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Enhanced Default Mode Network Functional Connectivity Links With Electroconvulsive Therapy Response in Major Depressive Disorder

International Journal of Psychophysiology ◽

10.1016/j.ijpsycho.2021.07.414 ◽

2021 ◽

Vol 168 ◽

pp. S146

Author(s):

Yajing Pang ◽

Qiang Wei ◽

Yanghua Tian ◽

Jiaojian Wang

Keyword(s):

Major Depressive Disorder ◽

Functional Connectivity ◽

Depressive Disorder ◽

Electroconvulsive Therapy ◽

Default Mode Network ◽

Therapy Response ◽

Major Depressive ◽

Default Mode

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Preventive Effect of Liothyronine on Electroconvulsive Therapy-Induced Memory Deficit in Patients with Major Depressive Disorder: A Double-Blind Controlled Clinical Trial

BioMed Research International ◽

10.1155/2015/503918 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Arash Mohagheghi ◽

Asghar Arfaie ◽

Shahrokh Amiri ◽

Masoud Nouri ◽

Salman Abdi ◽

...

Keyword(s):

Clinical Trial ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Electroconvulsive Therapy ◽

Visual Memory ◽

Memory Deficit ◽

Control Group ◽

Major Depressive ◽

Double Blind ◽

The Impact

Introduction and Objective. Despite the effectiveness of electroconvulsive therapy (ECT) in treating major depressive disorder (MDD), its cognitive side effects make it less popular. This study investigated the impact of liothyronine on ECT-induced memory deficit in patients with MDD.Methodology. This is a double-blind clinical trial, in which 60 patients with MDD who were referred for ECT were selected. The diagnosis was based on the criteria of DSM-IV-TR. Patients were divided randomly into two groups to receive either liothyronine (50 mcg every morning) or placebo. After the assessment with Wechsler Memory Scale-Revised (WMS-R) before first session of ECT, posttests were repeated again, two months after the completion of ECT.Findings. By controlling the pretest scores, the mean scores of the experimental group were higher than the control group in delayed recall, verbal memory, visual memory, general memory, and attention/concentration scales (P<0.05).Conclusion. Liothyronine may prevent ECT-induced memory impairment in patients with MDD. This study has been registered in IRCT underIRCT201401122660N2.

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