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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| Veröffentlicht in: | Brain stimulation Jg. 15; H. 6; S. 1486 - 1494 |
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| Abstract | 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. |
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| AbstractList | 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. 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. 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.BACKGROUNDThe 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.OBJECTIVEWe 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.METHODSA 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.RESULTSFollowing 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.CONCLUSIONECT-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. Background: 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. Objective: We investigated ECT-related perfusion changes in depressed patients and tested whether these changes correlate with clinical effects. Methods: 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. Results: 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. Conclusion: 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. |
| Author | Videbech, Poul Lindberg, Ulrich Rostrup, Egill Gbyl, Krzysztof Wiberg Larsson, Henrik Bo |
| Author_xml | – sequence: 1 givenname: Krzysztof orcidid: 0000-0001-6309-8736 surname: Gbyl fullname: Gbyl, Krzysztof email: krzysztof.gbyl@regionh.dk organization: Center for Neuropsychiatric Depression Research (CNDR), Mental Health Center Glostrup, Glostrup, Denmark – sequence: 2 givenname: Ulrich surname: Lindberg fullname: Lindberg, Ulrich organization: Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark – sequence: 3 givenname: Henrik Bo surname: Wiberg Larsson fullname: Wiberg Larsson, Henrik Bo organization: Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark – sequence: 4 givenname: Egill surname: Rostrup fullname: Rostrup, Egill organization: Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Denmark – sequence: 5 givenname: Poul surname: Videbech fullname: Videbech, Poul organization: Center for Neuropsychiatric Depression Research (CNDR), Mental Health Center Glostrup, Glostrup, Denmark |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36332891$$D View this record in MEDLINE/PubMed |
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| Keywords | Depression Functional MRI Electroconvulsive therapy Cerebral blood flow Cerebral perfusion Major depressive disorder |
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| SubjectTerms | 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 |
| Title | Cerebral perfusion is related to antidepressant effect and cognitive side effects of Electroconvulsive Therapy |
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