Cerebral perfusion is related to antidepressant effect and cognitive side effects of Electroconvulsive Therapy

The mechanisms underlying the antidepressant effect and cognitive side effects of Electroconvulsive Therapy (ECT) remain elusive. The measurement of cerebral perfusion provides an insight into brain physiology. We investigated ECT-related perfusion changes in depressed patients and tested whether th...

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Vydané v:Brain stimulation Ročník 15; číslo 6; s. 1486 - 1494
Hlavní autori: Gbyl, Krzysztof, Lindberg, Ulrich, Wiberg Larsson, Henrik Bo, Rostrup, Egill, Videbech, Poul
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Elsevier Inc 01.11.2022
Elsevier
Predmet:
Antidepressive Agents - therapeutic use
Cerebral blood flow
Cerebral perfusion
Cerebrovascular Circulation
Cognition
Depression
Electroconvulsive therapy
Electroconvulsive Therapy - adverse effects
Electroconvulsive Therapy - methods
Functional MRI
Humans
Magnetic Resonance Imaging
Major depressive disorder
Perfusion
Treatment Outcome
Depression
Functional MRI
Electroconvulsive therapy
Cerebral blood flow
Cerebral perfusion
Major depressive disorder
ISSN:1935-861X, 1876-4754, 1876-4754
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Shrnutí:The mechanisms underlying the antidepressant effect and cognitive side effects of Electroconvulsive Therapy (ECT) remain elusive. The measurement of cerebral perfusion provides an insight into brain physiology. We investigated ECT-related perfusion changes in depressed patients and tested whether these changes correlate with clinical effects. A sample of 22 in-patients was examined at three time points: 1) within two days before, 2) within one week after, and 3) six months after an ECT series. Cerebral perfusion was quantified using arterial spin labeling magnetic resonance imaging. The primary regions of interest were the bilateral dorsolateral prefrontal cortices (DL-PFC) and hippocampi. The depression severity was assessed by the six-item Hamilton Depression Rating Scale, and cognitive performance by the Screen for Cognitive Impairment in Psychiatry. A linear mixed model and partial correlation were used for statistical analyses. Following an ECT series, perfusion decreased in the right (−6.0%, p = .01) and left DL-PFC (−5.6%, p = .001). Perfusion increased in the left hippocampus (4.8%, p = .03), while on the right side the increase was insignificant (2.3%, p = .23). A larger perfusion reduction in the right DL-PFC correlated with a better antidepressant effect, and a larger perfusion increase in the right hippocampus with worse cognitive impairment. ECT-induced attenuation of prefrontal activity may be related to clinical improvement, whereas a hippocampal process triggered by the treatment is likely associated with cognitive side effects. •Following ECT, prefrontal perfusion decreases, and hippocampal perfusion increases.•The reduction in prefrontal perfusion may be related to the antidepressant effect.•The increase in hippocampal perfusion may be related to cognitive side effects.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1935-861X
1876-4754
1876-4754
DOI:10.1016/j.brs.2022.10.007