Altered neural activity in the reward-related circuit and executive control network associated with amelioration of anhedonia in major depressive disorder by electroconvulsive therapy

Zhang, Ting; He, Kai; Bai, Tongjian; Lv, Huaming; Xie, Xiaohui; Nie, Jiajia; Xie, Wen; Zhu, Chunyan; Wang, Kai; Tian, Yanghua

doi:10.1016/j.pnpbp.2020.110193

Cited by 26 publications

(17 citation statements)

References 46 publications

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“…In other words, ECT does not seem to cause any consistent changes in the brain on the local level (as measured by fALFF and ReHo), nor on the global network-like level (as measured by DC, and seed-based/network-based FC). This is not in line with previous (small-scale) fMRI studies reporting functional changes in frontal areas and a normalization of hippocampal connectivity following ECT [15,17,18,33]. It should be noted that some of the aforementioned studies lacked a control group in their analyses.…”

Section: Functional Brain Changescontrasting

confidence: 72%

“…For example, one study reported increased ALFF values in the anterior cingulate cortex and middle frontal gyrus following ECT while decreased values in the precentral gyrus and superior frontal gyrus also have been reported [15-16]. Proximal to these regions, ALFF and DC have shown to increase in the dorsomedial/lateral prefrontal cortex, as well as the bilateral orbitofrontal cortex following ECT, all of which are involved in reward and executive networks [17]. Furthermore, an increase in FC in the right hippocampus to the left superior temporal lobe correlated with symptom improvement [18], as well as an increase in FC from the anterior cingulate cortex to hippocampal, orbitofrontal cortex, and temporal pole regions [15].…”

Section: Introductionmentioning

confidence: 99%

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Multimodal multi-center analysis of electroconvulsive therapy effects: brainwide gray matter increase without functional changes

Mortel

Bruin

Thomas

et al. 2022

Preprint

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Background: Electroconvulsive therapy (ECT) is an effective treatment for severe depression and induces gray matter (GM) increases in the brain. Small-scale studies suggest that ECT also leads to changes in brain functioning, but findings are inconsistent. In this study, we investigated the influence of ECT on changes in both brain structure and function and their relation to clinical improvement using multicenter neuroimaging data from the Global ECT-MRI Research Collaboration (GEMRIC). Methods: We analyzed T1-weighted structural magnetic resonance imaging (MRI) and functional resting-state MRI data of 88 individuals (49 male) with treatment-resistant depression before and within two weeks after ECT. We performed voxel-based morphometry on the structural data and calculated fractional amplitudes of low-frequency fluctuations, regional homogeneity, degree centrality, functional connectomics, and hippocampus connectivity for the functional data in both unimodal and multimodal analyses. Longitudinal effects in the ECT group were compared to repeated measures of healthy controls (n=27). Results: Wide-spread increases in GM volume were found in patients following ECT. In contrast, no changes in any of the functional measures were observed, and there were no significant differences in structural or functional changes between ECT responders and non-responders. Multimodal analysis revealed that volume increases in the striatum, supplementary motor area and fusiform gyrus were associated with local changes in brain function. Conclusion: These results confirm wide-spread increases in GM volume, but suggest that this is not accompanied by functional changes or associated with clinical response. Instead, focal changes in brain function appear related to individual differences in brain volume increases.

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Section: Functional Brain Changescontrasting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Multimodal multi-center analysis of electroconvulsive therapy effects: brainwide gray matter increase without functional changes

Mortel

Bruin

Thomas

et al. 2022

Preprint

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“…In contrast to the QIDS-C and NA scores, the PA and hedonism scores increased significantly during active ECT treatment but did not change significantly in the 12 weeks after ECT. This indicates that the improvement in PA and hedonism was maintained for a substantial period, potentially through prolonged increases in gray matter volume and alterations in the activity of the brain's reward circuitry 23,41 …”

Section: Discussionmentioning

confidence: 99%

The Effect of Electroconvulsive Therapy on Positive Affect and Hedonism in Patients With Depression

Crauwels

Vansteelandt

Obbels

et al. 2021

J ECT

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ObjectivesThe outcome of antidepressant treatments is generally assessed with standardized symptom scales such as the Quick Inventory of Depressive Symptomatology–Clinician Rating (QIDS-C). These scales, however, might not reflect patients' expectations for treatment, including a recovery of positive affect (PA) and hedonism. The Leuven Affect and Pleasure Scale (LAPS) was developed to better reflect patients' expectations for treatment. We used the LAPS to investigate changes in PA and hedonism alongside depressive symptoms during electroconvulsive therapy (ECT) and over 12 weeks after treatment.MethodsFifty-three patients with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, depressive episode, referred for ECT, were included in this prospective study. The LAPS and QIDS-C were administered before and 1 and 12 weeks after the ECT course. LAPS normative levels were obtained in 149 healthy controls.ResultsPearson correlations revealed only moderate overlap of the QIDS-C with PA and hedonism. Piecewise linear mixed models indicated significant improvements in depressive symptoms (QIDS-C and LAPS negative affect), PA, and hedonism during ECT. In the 12 weeks after ECT treatment, negative affect and QIDS-C further improved, but PA and hedonism plateaued. Exploratory analyses indicated that only fully remitted patients (QIDS-C) attained normative levels on PA and hedonism at 12 weeks after ECT.ConclusionsStandardized symptom scales (QIDS-C) may incompletely reflect clinical change in ECT treatment for depression. Although ECT improved depressive symptoms, PA, and hedonism in patients with depression, only fully remitted patients attained normative levels of PA and hedonism, due to plateaus in improvement. These plateaus were not observed for depressive symptoms, which further improved after ECT discontinuation.

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“…Patients signed informed consent and were instructed to fast for at least 8 hr before ECT. As our prior studies described (Bai et al., 2017; Zhang et al, 2020), a modified bi‐frontal ECT protocol using the Thymatron System IV Integrated ECT System (Somatics, Lake Bluff, IL, USA) was used. Patients underwent 6 to 12 sessions of ECT according to their therapeutic response.…”

Section: Methodsmentioning

confidence: 99%

Functional and structural alterations in the pain‐related circuit in major depressive disorder induced by electroconvulsive therapy

Zhang

Hou

Bai

et al. 2021

J of Neuroscience Research

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Altered neural activity in the reward-related circuit and executive control network associated with amelioration of anhedonia in major depressive disorder by electroconvulsive therapy

Cited by 26 publications

References 46 publications

Multimodal multi-center analysis of electroconvulsive therapy effects: brainwide gray matter increase without functional changes

Multimodal multi-center analysis of electroconvulsive therapy effects: brainwide gray matter increase without functional changes

The Effect of Electroconvulsive Therapy on Positive Affect and Hedonism in Patients With Depression

Functional and structural alterations in the pain‐related circuit in major depressive disorder induced by electroconvulsive therapy

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