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Laroy M, Emsell L, Vandenbulcke M, Bouckaert F. Mapping electroconvulsive therapy induced neuroplasticity: Towards a multilevel understanding of the available clinical literature - A scoping review. Neurosci Biobehav Rev 2025; 173:106143. [PMID: 40222573 DOI: 10.1016/j.neubiorev.2025.106143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2025] [Revised: 04/04/2025] [Accepted: 04/07/2025] [Indexed: 04/15/2025]
Abstract
Since its introduction in 1938, the precise mechanism underlying the efficacy of electroconvulsive therapy (ECT) in treating severe psychiatric disorders remains elusive. This paper presents a comprehensive scoping review aimed to collate and summarize findings from clinical studies on neuroplastic changes induced by ECT. The review categorizes neuroplasticity into molecular, structural, and functional domains, offering a multilevel view of current research and its limitations. Molecular findings detail the varied responses of neurotrophic factors and neurotransmitters post-ECT, highlighting inconsistent evidence on their clinical relevance. Structural neuroplasticity is explored through changes in brain volume, cortical thickness, and white matter properties, presenting ECT as a potent stimulator of brain architecture alterations. Functional plasticity examines ECT's impact on brain function through diverse neuroimaging techniques, suggesting significant yet complex modifications in brain network connectivity and activity. The review emphasizes the multilevel nature of these neuroplasticity levels and their collective role in ECT's therapeutic outcomes. Methodological considerations-including sample size, patient heterogeneity, and variability in assessment timing-emerge as recurring themes in the literature, underscoring the need for more consistent and rigorous research designs. By outlining a cohesive framework of changes in neuroplasticity due to ECT, this review provides initial steps towards a deeper comprehension of ECT's mechanisms.
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Affiliation(s)
- Maarten Laroy
- KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry, Leuven B-3000, Belgium; Psychiatric Neuromodulation Centre, University Psychiatric Center KU Leuven, Leuven B-3000, Belgium.
| | - Louise Emsell
- KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry, Leuven B-3000, Belgium; Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven B-3000, Belgium; KU Leuven, Leuven Brain Institute, Department of Imaging and Pathology, Translational MRI, Leuven B-3000, Belgium
| | - Mathieu Vandenbulcke
- KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry, Leuven B-3000, Belgium; Psychiatric Neuromodulation Centre, University Psychiatric Center KU Leuven, Leuven B-3000, Belgium; Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven B-3000, Belgium
| | - Filip Bouckaert
- KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry, Leuven B-3000, Belgium; Psychiatric Neuromodulation Centre, University Psychiatric Center KU Leuven, Leuven B-3000, Belgium; Geriatric Psychiatry, University Psychiatric Center KU Leuven, Leuven B-3000, Belgium
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Borgers T, Zwiky E, Klug M, Enneking V, Fisch L, Klein L, Neutz L, Leehr EJ, Opel N, König P, Schöniger K, Küttner A, Selle J, Dannlowski U, Redlich R. Changes in brain function during negative emotion processing following cognitive-behavioural therapy in depressive disorders. Br J Psychiatry 2025:1-8. [PMID: 40329828 DOI: 10.1192/bjp.2025.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2025]
Abstract
BACKGROUND Cognitive-behavioural therapy (CBT) is a first-line treatment for depressive disorders, but research on its neurobiological mechanisms is limited. Given the heterogeneity in CBT response, investigating the neurobiological effects of CBT may improve response prediction and outcomes. AIMS To examine brain functional changes during negative emotion processing following naturalistic CBT. METHOD In this case-control study, 59 patients with depressive disorders were investigated before and after 20 CBT sessions using a negative-emotion-processing paradigm during functional magnetic resonance imaging, clinical interviews and depressive symptom questionnaires. Healthy controls (n = 60) were also assessed twice within an equivalent time interval. Patients were classified into subgroups based on changes in diagnosis according to DSM-IV criteria (n = 40 responders, n = 19 non-responders). Brain activity changes were examined using group × time analysis of variance for limbic areas, and at the whole-brain level. RESULTS Analyses yielded a significant group × time interaction in the hippocampus (P family-wise error [PFWE] = 0.022, η P 2 = 0.101), and a significant main effect of time in the dorsal anterior cingulate cortex (PFWE = 0.043, η P ² = 0.098), resulting from activity decreases following CBT (PFWE ≤ 0.024, η P ² ≤ 0.233), with no changes in healthy controls. Hippocampal activity decreases were driven by responders (PFWE ≤ 0.020, η P ² ≤ 0.260) and correlated with symptom improvement (r = 0.293, P = 0.024). Responders exhibited higher pre-treatment hippocampal activity (PFWE = 0.017, η P ² = 0.189). CONCLUSIONS Following CBT, reduced activity in emotion-processing regions was observed in patients with depressive disorders, with hippocampal activity decreases linked to treatment response. This suggests successful CBT could correct biased emotion processing, potentially by altering activity in key areas of emotion processing. Hippocampal activity may function as a predictive marker of CBT response.
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Affiliation(s)
- Tiana Borgers
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Esther Zwiky
- Department of Psychology, University of Halle, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
| | - Melissa Klug
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Lukas Fisch
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Lydia Klein
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Laura Neutz
- Institute for Translational Psychiatry, University of Münster, Germany
| | | | - Nils Opel
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Halle-Jena-Magdeburg, Germany
| | - Philine König
- Department of Psychology, University of Halle, Germany
| | | | | | - Janine Selle
- Department of Psychology, University of Halle, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Germany
- Department of Psychology, University of Halle, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Halle-Jena-Magdeburg, Germany
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Peng W, Liu S, Yi J. Transdiagnostic and Disorder-specific Neural Correlates of Emotion Processing in Major Depressive Disorder and Borderline Personality Disorder: Coordinate-based and Image-based Comparative Meta-Analyses. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2025:S2451-9022(25)00122-3. [PMID: 40180313 DOI: 10.1016/j.bpsc.2025.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2024] [Revised: 03/18/2025] [Accepted: 03/19/2025] [Indexed: 04/05/2025]
Abstract
BACKGROUND Major Depressive Disorder (MDD) and Borderline Personality Disorder (BPD) involve substantial impairments in negative and positive emotions processing. This meta-analysis aims to identify both transdiagnostic and disorder-specific neural abnormalities during the processing of negative and positive stimuli for MDD and BPD. METHODS The current coordinate-based and image-based meta-analyses comprised 42 fMRI studies involving MDD (42 Negative studies vs. 22 Positive studies; 1,532 MDD patients vs. 1,481 healthy controls) and 25 involving BPD (23 Negative studies vs. 7 Positive studies; 522 BPD patients vs. 519 healthy controls). RESULTS Compared to healthy controls, MDD patients exhibited hyporeactivity in left precentral gyrus during negative emotion processing, and decreased activation in left temporal lobe, insula, and bilateral anterior cingulate cortex during positive emotion processing, while BPD patients displayed hyperreactivity in left hippocampus and amygdala and hyporeactivity in right inferior frontal gyrus during negative emotion processing. Compared to BPD, MDD exhibited greater hyporeactivity in bilateral anterior cingulate cortex during negative emotion processing and in left middle temporal gyrus during positive emotion processing. The transdiagnostic hyporeactivity of BPD and MDD was mainly located in left inferior and right middle frontal gyrus during negative emotion processing. CONCLUSIONS Our findings highlight both distinct and transdiagnostic neural mechanisms of emotion processing for MDD and BPD.
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Affiliation(s)
- Wanrong Peng
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha 410011, China; Medical Psychological Institute, Central South University, Changsha 410011, China; National Clinical Research Center for Mental Disorders, Changsha 410011, China
| | - Suyao Liu
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha 410011, China; Medical Psychological Institute, Central South University, Changsha 410011, China; National Clinical Research Center for Mental Disorders, Changsha 410011, China
| | - Jinyao Yi
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha 410011, China; Medical Psychological Institute, Central South University, Changsha 410011, China; National Clinical Research Center for Mental Disorders, Changsha 410011, China.
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Zwiky E, König P, Herrmann RM, Küttner A, Selle J, Ptasczynski LE, Schöniger K, Rutenkröger M, Enneking V, Borgers T, Klug M, Dohm K, Leehr EJ, Bauer J, Dannlowski U, Redlich R. How movies move us - movie preferences are linked to differences in neuronal emotion processing of fear and anger: an fMRI study. Front Behav Neurosci 2024; 18:1396811. [PMID: 38895596 PMCID: PMC11185070 DOI: 10.3389/fnbeh.2024.1396811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/09/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction As a source of audio-visual stimulation, movies expose people to various emotions. Interestingly, several genres are characterized by negative emotional content. Albeit theoretical approaches exist, little is known about preferences for specific movie genres and the neuronal processing of negative emotions. Methods We investigated associations between movie genre preference and limbic and reward-related brain reactivity to close this gap by employing an fMRI paradigm with negative emotional faces in 257 healthy participants. We compared the functional activity of the amygdala and the nucleus accumbens (NAcc) between individuals with a preference for a particular movie genre and those without such preference. Results and discussion Amygdala activation was relatively higher in individuals with action movie preference (p TFCE-FWE = 0.013). Comedy genre preference was associated with increased amygdala (p TFCE-FWE = 0.038) and NAcc activity (p TFCE-FWE = 0.011). In contrast, crime/thriller preference (amygdala: p TFCE-FWE ≤ 0.010, NAcc: p TFCE-FWE = 0.036), as well as documentary preference, was linked to the decreased amygdala (p TFCE-FWE = 0.012) and NAcc activity (p TFCE-FWE = 0.015). The study revealed associations between participants' genre preferences and brain reactivity to negative affective stimuli. Interestingly, preferences for genres with similar emotion profiles (action, crime/thriller) were associated with oppositely directed neural activity. Potential links between brain reactivity and susceptibility to different movie-related gratifications are discussed.
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Affiliation(s)
- Esther Zwiky
- Department of Psychology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Philine König
- Department of Psychology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Rebekka Maria Herrmann
- Department of Psychology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Antonia Küttner
- Department of Psychology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Janine Selle
- Department of Psychology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Halle (Saale), Germany
| | - Lena Esther Ptasczynski
- Department of Psychology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Department of Psychiatry and Neurosciences, Charité –Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt University of Berlin, Berlin, Germany
| | - Konrad Schöniger
- Department of Psychology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Mareike Rutenkröger
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tiana Borgers
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Melissa Klug
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jochen Bauer
- Department of Radiology, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ronny Redlich
- Department of Psychology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Halle (Saale), Germany
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Jena-Magdeburg-Halle, Halle (Saale), Germany
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Stuiver S, Pottkämper JCM, Verdijk JPAJ, Ten Doesschate F, Aalbregt E, van Putten MJAM, Hofmeijer J, van Waarde JA. Cortical excitation/inhibition ratios in patients with major depression treated with electroconvulsive therapy: an EEG analysis. Eur Arch Psychiatry Clin Neurosci 2024; 274:793-802. [PMID: 37947826 PMCID: PMC11127883 DOI: 10.1007/s00406-023-01708-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/15/2023] [Indexed: 11/12/2023]
Abstract
Electroconvulsive therapy (ECT) is an effective treatment for major depression, but its working mechanisms are poorly understood. Modulation of excitation/inhibition (E/I) ratios may be a driving factor. Here, we estimate cortical E/I ratios in depressed patients and study whether these ratios change over the course of ECT in relation to clinical effectiveness. Five-minute resting-state electroencephalography (EEG) recordings of 28 depressed patients were recorded before and after their ECT course. Using a novel method based on critical dynamics, functional E/I (fE/I) ratios in the frequency range of 0.5-30 Hz were estimated in frequency bins of 1 Hz for the whole brain and for pre-defined brain regions. Change in Hamilton Depression Rating Scale (HDRS) score was used to estimate clinical effectiveness. To account for test-retest variability, repeated EEG recordings from an independent sample of 31 healthy controls (HC) were included. At baseline, no differences in whole brain and regional fE/I ratios were found between patients and HC. At group level, whole brain and regional fE/I ratios did not change over the ECT course. However, in responders, frontal fE/I ratios in the frequencies 12-28 Hz increased significantly (pFDR < 0.05 [FDR = false discovery rate]) over the ECT course. In non-responders and HC, no changes occurred over time. In this sample, frontal fE/I ratios increased over the ECT course in relation to treatment response. Modulation of frontal fE/I ratios may be an important mechanism of action of ECT.
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Affiliation(s)
- Sven Stuiver
- Technical Medical Centre, Faculty of Science and Technology, Clinical Neurophysiology, University of Twente, Hallenweg 15, 7522NB, Enschede, The Netherlands.
- Department of Psychiatry, Rijnstate Hospital, Wagnerlaan 55, P.O. Box 9555, 6815AD, Arnhem, The Netherlands.
| | - Julia C M Pottkämper
- Technical Medical Centre, Faculty of Science and Technology, Clinical Neurophysiology, University of Twente, Hallenweg 15, 7522NB, Enschede, The Netherlands
- Department of Psychiatry, Rijnstate Hospital, Wagnerlaan 55, P.O. Box 9555, 6815AD, Arnhem, The Netherlands
- Department of Neurology, Rijnstate Hospital, Wagnerlaan 55, 6815AD, Arnhem, The Netherlands
| | - Joey P A J Verdijk
- Technical Medical Centre, Faculty of Science and Technology, Clinical Neurophysiology, University of Twente, Hallenweg 15, 7522NB, Enschede, The Netherlands
- Department of Psychiatry, Rijnstate Hospital, Wagnerlaan 55, P.O. Box 9555, 6815AD, Arnhem, The Netherlands
| | - Freek Ten Doesschate
- Department of Psychiatry, Rijnstate Hospital, Wagnerlaan 55, P.O. Box 9555, 6815AD, Arnhem, The Netherlands
| | - Eva Aalbregt
- Department of Surgery, Amsterdam UMC Location Vumc, Boelelaan 1108, 1081HZ, Amsterdam, The Netherlands
| | - Michel J A M van Putten
- Technical Medical Centre, Faculty of Science and Technology, Clinical Neurophysiology, University of Twente, Hallenweg 15, 7522NB, Enschede, The Netherlands
| | - Jeannette Hofmeijer
- Technical Medical Centre, Faculty of Science and Technology, Clinical Neurophysiology, University of Twente, Hallenweg 15, 7522NB, Enschede, The Netherlands
- Department of Neurology, Rijnstate Hospital, Wagnerlaan 55, 6815AD, Arnhem, The Netherlands
| | - Jeroen A van Waarde
- Department of Psychiatry, Rijnstate Hospital, Wagnerlaan 55, P.O. Box 9555, 6815AD, Arnhem, The Netherlands
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6
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Li Y, Liu X. Efficacy and safety of non-invasive brain stimulation in combination with antidepressants in adolescents with depression: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1288338. [PMID: 38426000 PMCID: PMC10902042 DOI: 10.3389/fpsyt.2024.1288338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
Objective Non-invasive brain stimulation (NIBS) is beneficial to adult patients with depression, but its safety and efficacy in combination with antidepressants in children and adolescents with depression are not clear. We conducted a preliminary meta-analysis to objectively evaluate its clinical effect and provide information for future research and clinical practice. Methods PubMed, Cochrane Library, Embase, and Web of Science were searched systematically to find clinical trials published in English before April 11, 2023. Stata software was used for meta-analysis, and random or fixed effect models were used to combine effect sizes. Results Nine studies were eligible and included (n = 393). No articles about children were included in the analysis. The results showed that the remission rate was 40% (95% confidence interval [CI]: 13% to 71%). The scores of Children's Depression Rating Scale (CRDS) and Hamilton's depression scale (HAMD) significantly decreased compared to baseline value (MD = -27.04, 95% CI: -30.95, -23.12 and MD = -12.78, 95% CI: -19.55 to -6.01). In addition, the incidence of all adverse events was 13% (95% CI: 5%, 23%), and all were minor pain-related events. Conclusion The combination of NIBS and antidepressants has been shown to notably alleviate depressive symptoms in adolescents, offering a considerable level of safety. This therapeutic synergy is particularly effective in patients with major depressive disorder, where repetitive transcranial magnetic stimulation augmented with antidepressants can enhance the amelioration of depressive symptoms. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023442215, PROSPERO CRD42023442215.
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Affiliation(s)
| | - Xiaoyan Liu
- Department of Psychiatry, Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Reis JAS, Rossi GN, L Osório F, Bouso JC, Hallak JEC, Dos Santos RG. Interventions for deficits in recognition of emotions in facial expressions in major depressive disorder: An updated systematic review of clinical trials. Neurosci Biobehav Rev 2023; 153:105367. [PMID: 37619644 DOI: 10.1016/j.neubiorev.2023.105367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 08/26/2023]
Abstract
The recognition of emotions in facial expressions (REFE) is a core construct of social cognition. In the last decades, studies have showed that REFE is altered in major depressive disorder (MDD), but the evidence is conflicting. Thus, we conducted a systematic review of clinical trials involving therapeutic interventions in MDD and any evaluation of REFE to update (2018-2023) and systematically evaluate the evidence derived from controlled clinical trials on the effects of therapeutic strategies to MDD on the REFE. Eleven studies were included in the final review. Some interventions, including drugs (ketamine, bupropion, psylocibin) and non-pharmacological strategies (psychotherapy) seem to be able to reduce pre-existing REFE biases in MDD patients. However, there was a high heterogeneity in the evaluated studies, in terms of sample, interventions, tasks and results. Further studies and more consistent evaluation tools are highly needed to better understand nuanced deficits and specific actions of different treatment options.
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Affiliation(s)
- José Augusto Silva Reis
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University São Paulo, SP, Brazil.
| | - Giordano Novak Rossi
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University São Paulo, SP, Brazil.
| | - Flávia L Osório
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - José Carlos Bouso
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University São Paulo, SP, Brazil; International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, Spain; Universitat Rovira i Virgili, Department of Psychology and Research Center for Behavior Assessment (CRAMC), Tarragona, Spain.
| | - Jaime Eduardo Cecílio Hallak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil; International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, Spain.
| | - Rafael Guimarães Dos Santos
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil; International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, Spain.
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Domke AK, Hempel M, Hartling C, Stippl A, Carstens L, Gruzman R, Herrera Melendez AL, Bajbouj M, Gärtner M, Grimm S. Functional connectivity changes between amygdala and prefrontal cortex after ECT are associated with improvement in distinct depressive symptoms. Eur Arch Psychiatry Clin Neurosci 2023; 273:1489-1499. [PMID: 36715751 PMCID: PMC10465635 DOI: 10.1007/s00406-023-01552-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/09/2023] [Indexed: 01/31/2023]
Abstract
Electroconvulsive therapy (ECT) is one of the most effective treatments for treatment-resistant depression. However, the underlying mechanisms of action are not yet fully understood. The investigation of depression-specific networks using resting-state fMRI and the relation to differential symptom improvement might be an innovative approach providing new insights into the underlying processes. In this naturalistic study, we investigated the relationship between changes in resting-state functional connectivity (rsFC) and symptom improvement after ECT in 21 patients with treatment-resistant depression. We investigated rsFC before and after ECT and focused our analyses on FC changes directly related to symptom reduction and on FC at baseline to identify neural targets that might predict individual clinical responses to ECT. Additional analyses were performed to identify the direct relationship between rsFC change and symptom dimensions such as sadness, negative thoughts, detachment, and neurovegetative symptoms. An increase in rsFC between the left amygdala and left dorsolateral prefrontal cortex (DLPFC) after ECT was related to overall symptom reduction (Bonferroni-corrected p = 0.033) as well as to a reduction in specific symptoms such as sadness (r = 0.524, uncorrected p = 0.014), negative thoughts (r = 0.700, Bonferroni-corrected p = 0.002) and detachment (r = 0.663, p = 0.004), but not in neurovegetative symptoms. Furthermore, high baseline rsFC between the left amygdala and the right frontal pole (FP) predicted treatment outcome (uncorrected p = 0.039). We conclude that changes in FC in regions of the limbic-prefrontal network are associated with symptom improvement, particularly in affective and cognitive dimensions. Frontal-limbic connectivity has the potential to predict symptom improvement after ECT. Further research combining functional imaging biomarkers and a symptom-based approach might be promising.
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Affiliation(s)
- Ann-Kathrin Domke
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Moritz Hempel
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
| | - Corinna Hartling
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Anna Stippl
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Luisa Carstens
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
| | - Rebecca Gruzman
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
| | - Ana Lucia Herrera Melendez
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Malek Bajbouj
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Matti Gärtner
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
| | - Simone Grimm
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, 8032, Zurich, Switzerland
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9
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Chen X, Yang H, Cui LB, Li X. Neuroimaging study of electroconvulsive therapy for depression. Front Psychiatry 2023; 14:1170625. [PMID: 37363178 PMCID: PMC10289201 DOI: 10.3389/fpsyt.2023.1170625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Electroconvulsive therapy (ECT) is an important treatment for depression. Although it is known as the most effective acute treatment for severe mood disorders, its therapeutic mechanism is still unclear. With the rapid development of neuroimaging technology, various neuroimaging techniques have been available to explore the alterations of the brain by ECT, such as structural magnetic resonance imaging, functional magnetic resonance imaging, magnetic resonance spectroscopy, positron emission tomography, single photon emission computed tomography, arterial spin labeling, etc. This article reviews studies in neuroimaging on ECT for depression. These findings suggest that the neurobiological mechanism of ECT may regulate the brain functional activity, and neural structural plasticity, as well as balance the brain's neurotransmitters, which finally achieves a therapeutic effect.
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Affiliation(s)
- Xiaolu Chen
- The First Branch, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hanjie Yang
- Department of Neurology, The Thirteenth People’s Hospital of Chongqing, Chongqing, China
| | - Long-Biao Cui
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Schizophrenia Imaging Lab, Fourth Military Medical University, Xi’an, China
| | - Xiao Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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10
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Wang YB, Song NN, Ding YQ, Zhang L. Neural plasticity and depression treatment. IBRO Neurosci Rep 2023; 14:160-184. [PMID: 37388497 PMCID: PMC10300479 DOI: 10.1016/j.ibneur.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/29/2022] [Accepted: 09/01/2022] [Indexed: 12/08/2022] Open
Abstract
Depression is one of the most common mental disorders, which can lead to a variety of emotional problems and even suicide at its worst. As this neuropsychiatric disorder causes the patients to suffer a lot and function poorly in everyday life, it is imposing a heavy burden on the affected families and the whole society. Several hypotheses have been proposed to elucidate the pathogenesis of depression, such as the genetic mutations, the monoamine hypothesis, the hypothalamic-pituitary-adrenal (HPA) axis hyperactivation, the inflammation and the neural plasticity changes. Among these models, neural plasticity can occur at multiple levels from brain regions, cells to synapses structurally and functionally during development and in adulthood. In this review, we summarize the recent progresses (especially in the last five years) on the neural plasticity changes in depression under different organizational levels and elaborate different treatments for depression by changing the neural plasticity. We hope that this review would shed light on the etiological studies for depression and on the development of novel treatments.
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Affiliation(s)
- Yu-Bing Wang
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) and Department of Anatomy, Histology and Embryology, Tongji University School of Medicine, Shanghai 200092, China
| | - Ning-Ning Song
- Department of Laboratory Animal Science, Fudan University, Shanghai 200032, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudfan University, Shanghai 200032, China
| | - Yu-Qiang Ding
- Department of Laboratory Animal Science, Fudan University, Shanghai 200032, China
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudfan University, Shanghai 200032, China
| | - Lei Zhang
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) and Department of Anatomy, Histology and Embryology, Tongji University School of Medicine, Shanghai 200092, China
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11
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Gruzman R, Hartling C, Domke AK, Stippl A, Carstens L, Bajbouj M, Gärtner M, Grimm S. Investigation of Neurofunctional Changes Over the Course of Electroconvulsive Therapy. Int J Neuropsychopharmacol 2022; 26:20-31. [PMID: 36173403 PMCID: PMC9850659 DOI: 10.1093/ijnp/pyac063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/13/2022] [Accepted: 09/28/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is an effective treatment for patients suffering from depression. Yet the exact neurobiological mechanisms underlying the efficacy of ECT and indicators of who might respond best to it remain to be elucidated. Identifying neural markers that can inform about an individual's response to ECT would enable more optimal treatment strategies and increase clinical efficacy. METHODS Twenty-one acutely depressed inpatients completed an emotional working memory task during functional magnetic resonance imaging before and after receiving treatment with ECT. Neural activity was assessed in 5 key regions associated with the pathophysiology of depression: bilateral dorsolateral prefrontal cortex and pregenual, subgenual, and dorsal anterior cingulate cortex. Associations between brain activation and clinical improvement, as reflected by Montgomery-Åsberg Depression Rating Scale scores, were computed using linear regression models, t tests, and Pearson correlational analyses. RESULTS Significant neurobiological prognostic markers or changes in neural activity from pre- to post ECT did not emerge. CONCLUSIONS We could not confirm normalization effects and did not find significant neural markers related to treatment response. These results demonstrate that the search for reliable and clinically useful biomarkers for ECT treatment remains in its initial stages and still faces challenges.
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Affiliation(s)
- Rebecca Gruzman
- Correspondence: Rebecca Gruzman, MSc, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197 Berlin, Germany ()
| | | | - Ann-Kathrin Domke
- Charité Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Anna Stippl
- Charité Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | | | - Malek Bajbouj
- Charité Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Matti Gärtner
- MSB Medical School Berlin, Berlin, Germany,Charité Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Berlin, Germany
| | - Simone Grimm
- MSB Medical School Berlin, Berlin, Germany,Charité Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Berlin, Germany,Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, University of Zurich, Switzerland
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12
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Li Y, Li Y, Wei Q, Bai T, Wang K, Wang J, Tian Y. Mapping intrinsic functional network topological architecture in major depression disorder after electroconvulsive therapy. J Affect Disord 2022; 311:103-109. [PMID: 35594966 DOI: 10.1016/j.jad.2022.05.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/07/2022] [Accepted: 05/12/2022] [Indexed: 12/22/2022]
Abstract
Disrupted topological organization of functional brain networks has been well documented in major depressive disorder (MDD). However, there is no report about how electroconvulsive therapy (ECT), a rapid way for depression remission, affects whole-brain functional network topological architecture to improve clinical symptoms in individuals with MDD. In this study, resting-state functional magnetic resonance imaging (rs-fMRI) data were collected for twenty-four MDD patients before and after receiving ECT and 25 gender-, age- and education-matched healthy controls (HC). The functional brain network for each subject was mapped using Brainnetome Atlas and graph-theory was applied to measure topological properties for both binary and weighted network. The results showed that ECT can significantly increase shortest path length and decrease global efficiency in MDD patients. In addition, significant alterations in nodal degree, nodal efficiency as well as between nodal functional connectivity strength were found in MDD patients after ECT. The network nodes showing changed degree, efficiency and connectivity were primarily distributed in default mode network (DMN), fronto-parietal network (FPN), and limbic system. Our findings demonstrates that ECT improves depressive symptoms by reorganizing disrupted network topological architecture in MDD patients and highlights the important role of functional reorganization of DMN, FPN, and limbic network contributing to depression remission.
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Affiliation(s)
- Yuanyuan Li
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China
| | - Yue Li
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China
| | - Qiang Wei
- Department of Neurology, the First Hospital of Anhui Medical University, Hefei 230022, China
| | - Tongjian Bai
- Department of Neurology, the First Hospital of Anhui Medical University, Hefei 230022, China
| | - Kai Wang
- Department of Neurology, the First Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Anhui Medical University, School of Mental Health and Psychological Sciences, Hefei 230022, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China; Anhui Province clinical research center for neurological disease, Hefei 230022, China
| | - Jiaojian Wang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China; Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China.
| | - Yanghua Tian
- Department of Neurology, the First Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Anhui Medical University, School of Mental Health and Psychological Sciences, Hefei 230022, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China; Anhui Province clinical research center for neurological disease, Hefei 230022, China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230022, China.
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13
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Yang HG, Liu WV, Wen Z, Hu LH, Fan GG, Zha YF. Altered voxel-level whole-brain functional connectivity in multiple system atrophy patients with depression symptoms. BMC Psychiatry 2022; 22:279. [PMID: 35443639 PMCID: PMC9020004 DOI: 10.1186/s12888-022-03893-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/28/2022] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND It is yet unknown if the whole-brain resting-state network is altered in multiple system atrophy with symptoms of depression. This study aimed to investigate if and how depression symptoms in multiple system atrophy are associated with resting-state network dysfunction. METHODS We assessed the resting-state functional network matric using Degree centrality (DC) coupling with a second ROI-wise functional connectivity (FC) algorithm in a multimodal imaging case-control study that enrolled 32 multiple system atrophy patients with depression symptoms (MSA-D), 30 multiple system atrophy patients without depression symptoms (MSA-ND), and 34 healthy controls (HC). RESULTS Compared to HC, MSA-D showed more extensive DC hub dysfunction in the left precentral and right middle frontal cortex than MSA-ND. A direct comparison between MSA-D and MSA-ND detected increased DC in the right anterior cingulum cortex, but decreased DC in the left cerebellum lobule IV and lobule V, left middle pole temporal cortex, and right superior frontal cortex. Only right anterior cingulum cortex mean DC values showed a positive correlation with depression severity, and used ACC as seed, a second ROI-wise functional connectivity further revealed MSA-D patients showed decreased connectivity between the ACC and right thalamus and right middle temporal gyrus (MTG). CONCLUSIONS These findings revealed that dysfunction of rACC, right middle temporal lobe and right thalamus involved in depressed MSA. Our study might help to the understanding of the neuropathological mechanism of depression in MSA.
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Affiliation(s)
- Hua Guang Yang
- grid.412632.00000 0004 1758 2270Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060 China
| | | | - Zhi Wen
- grid.412632.00000 0004 1758 2270Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060 China
| | - Lan Hua Hu
- grid.412632.00000 0004 1758 2270Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060 China
| | - Guo Guang Fan
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, LN, China.
| | - Yun Fei Zha
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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14
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Subramanian S, Lopez R, Zorumski CF, Cristancho P. Electroconvulsive therapy in treatment resistant depression. J Neurol Sci 2022; 434:120095. [PMID: 34979372 DOI: 10.1016/j.jns.2021.120095] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/02/2021] [Accepted: 12/12/2021] [Indexed: 12/28/2022]
Abstract
Electroconvulsive therapy (ECT) is a treatment modality for patients with treatment resistant depression (TRD), defined as failure of two adequate antidepressant medication trials. We provide a qualitative review of ECT's effectiveness for TRD, methods to optimize ECT parameters to improve remission rates and side effect profiles, and ECT's proposed neurobiological mechanisms. Right unilateral (RUL) electrode placement has been shown to be as effective for major depression as bilateral ECT, and RUL is associated with fewer cognitive side effects. There is mixed evidence on how to utilize ECT to sustain remission (i.e., continuation ECT, psychotropic medications alone, or a combination of ECT and psychotropic medications). Related to neurobiological mechanisms, an increase in gray matter volume in the hippocampus-amygdala complex is reported post-ECT. High connectivity between the subgenual anterior cingulate and the middle temporal gyrus before ECT is associated with better treatment response. Rodent models have implicated changes in neurotransmitters including glutamate, GABA, serotonin, and dopamine in ECT's efficacy; however, findings in humans are limited. Altogether, while ECT remains a highly effective therapy, the neurobiological underpinnings associated with improvement of depression remain uncertain.
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Affiliation(s)
- Subha Subramanian
- Department of Psychiatry, Washington University in St Louis School of Medicine, St Louis, MO, USA; Department of Psychiatry, University of Texas Rio Grande Valley School of Medicine, Harlingen, TX, USA.
| | - Ruthzaine Lopez
- Department of Psychiatry, Washington University in St Louis School of Medicine, St Louis, MO, USA; Department of Psychiatry, University of Texas Rio Grande Valley School of Medicine, Harlingen, TX, USA
| | - Charles F Zorumski
- Department of Psychiatry, Washington University in St Louis School of Medicine, St Louis, MO, USA; Department of Psychiatry, University of Texas Rio Grande Valley School of Medicine, Harlingen, TX, USA
| | - Pilar Cristancho
- Department of Psychiatry, Washington University in St Louis School of Medicine, St Louis, MO, USA; Department of Psychiatry, University of Texas Rio Grande Valley School of Medicine, Harlingen, TX, USA
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15
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Borgers T, Kürten M, Kappelhoff A, Enneking V, Möllmann A, Schulte J, Klug M, Leehr EJ, Dohm K, Grotegerd D, Krause P, Zwiky E, Dannlowski U, Buhlmann U, Redlich R. Brain functional correlates of emotional face processing in body dysmorphic disorder. J Psychiatr Res 2022; 147:103-110. [PMID: 35030511 DOI: 10.1016/j.jpsychires.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 12/14/2021] [Accepted: 01/03/2022] [Indexed: 11/29/2022]
Abstract
Previous neuroimaging studies in body dysmorphic disorder (BDD) have focused on discordances in visual processing systems. However, little is known about brain functional aberrations in individuals with BDD during emotional face processing. An fMRI paradigm with negative emotional faces was employed in 20 individuals with BDD and 43 mentally healthy controls (HC). We compared functional activity and whole-brain connectivity patterns of the amygdala and the fusiform gyrus (FFG) between both groups. Regression analyses were performed for associations of body dysmorphic symptoms with brain activity and connectivity. Individuals with BDD exhibited higher activity in the left amygdala compared to HC (pFWE = .04) as well as increased functional connectivity of the left amygdala with a network including frontostriatal and temporal regions (pFWE < .05). The FFG revealed increased functional connectivity in individuals with BDD, mapping to brain areas such as the cingulate cortex and temporo-limbic regions (pFWE < .05). In HC, higher levels of body dysmorphic symptoms were associated with higher functional amygdala and FFG activity (pFWE < .05). Individuals with BDD show aberrant functional activity and connectivity patterns within the amygdala and the FFG for negative emotional face processing. Body dysmorphic symptoms in HC are associated with a mild pattern of brain functional alterations, which could emphasize the relevance of a dimensional approach in addition to diagnosis. Treatments for BDD could benefit from targeting visual misperception and evaluation processes upon confrontation with emotional information.
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Affiliation(s)
- Tiana Borgers
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany.
| | - Marla Kürten
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany; Institute of Psychology, University of Münster, Fliednerstrasse 21, 48149, Münster, Germany.
| | - Anna Kappelhoff
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany.
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany.
| | - Anne Möllmann
- Institute of Psychology, University of Bremen, Grazer Strasse 2, 28359, Bremen, Germany.
| | - Johanna Schulte
- Institute of Psychology, University of Münster, Fliednerstrasse 21, 48149, Münster, Germany.
| | - Melissa Klug
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany.
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany.
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany.
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany.
| | - Philine Krause
- Institute of Psychology, University of Halle, Emil Abderhaldenstraße 26, 06108, Halle, Germany.
| | - Esther Zwiky
- Institute of Psychology, University of Halle, Emil Abderhaldenstraße 26, 06108, Halle, Germany.
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany.
| | - Ulrike Buhlmann
- Institute of Psychology, University of Münster, Fliednerstrasse 21, 48149, Münster, Germany.
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany; Institute of Psychology, University of Halle, Emil Abderhaldenstraße 26, 06108, Halle, Germany.
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16
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Li XK, Qiu HT. Current progress in neuroimaging research for the treatment of major depression with electroconvulsive therapy. World J Psychiatry 2022; 12:128-139. [PMID: 35111584 PMCID: PMC8783162 DOI: 10.5498/wjp.v12.i1.128] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/20/2021] [Accepted: 09/06/2021] [Indexed: 02/06/2023] Open
Abstract
Electroconvulsive therapy (ECT) uses a certain amount of electric current to pass through the head of the patient, causing convulsions throughout the body, to relieve the symptoms of the disease and achieve the purpose of treatment. ECT can effectively improve the clinical symptoms of patients with major depression, but its therapeutic mechanism is still unclear. With the rapid development of neuroimaging technology, it is necessary to explore the neurobiological mechanism of major depression from the aspects of brain structure, brain function and brain metabolism, and to find that ECT can improve the brain function, metabolism and even brain structure of patients to a certain extent. Currently, an increasing number of neuroimaging studies adopt various neuroimaging techniques including functional magnetic resonance imaging (MRI), positron emission tomography, magnetic resonance spectroscopy, structural MRI, and diffusion tensor imaging to reveal the neural effects of ECT. This article reviews the recent progress in neuroimaging research on ECT for major depression. The results suggest that the neurobiological mechanism of ECT may be to modulate the functional activity and connectivity or neural structural plasticity in specific brain regions to the normal level, to achieve the therapeutic effect.
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Affiliation(s)
- Xin-Ke Li
- College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
| | - Hai-Tang Qiu
- Mental Health Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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17
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Lan Z, Zhang W, Wang D, Tan Z, Wang Y, Pan C, Xiao Y, Kuai C, Xue SW. Decreased modular segregation of the frontal-parietal network in major depressive disorder. Front Psychiatry 2022; 13:929812. [PMID: 35935436 PMCID: PMC9353222 DOI: 10.3389/fpsyt.2022.929812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Major depressive disorder (MDD) is a common psychiatric condition associated with aberrant large-scale distributed brain networks. However, it is unclear how the network dysfunction in MDD patients is characterized by imbalance or derangement of network modular segregation. Fifty-one MDD patients and forty-three matched healthy controls (HC) were recruited in the present study. We analyzed intrinsic brain activity derived from resting-state functional magnetic resonance imaging (R-fMRI) and then examined brain network segregation by computing the participation coefficient (PC). Further intra- and inter-modular connections analysis were preformed to explain atypical PC. Besides, we explored the potential relationship between the above graph theory measures and symptom severity in MDD. Lower modular segregation of the frontal-parietal network (FPN) was found in MDD compared with the HC group. The MDD group exhibited increased inter-module connections between the FPN and cingulo-opercular network (CON), between the FPN and cerebellum (Cere), between the CON and Cere. At the nodal level, the PC of the anterior prefrontal cortex, anterior cingulate cortex, inferior parietal lobule (IPL), and intraparietal sulcus showed larger in MDD. Additionally, the inter-module connections between the FPN and CON and the PC values of the IPL were negatively correlated with depression symptom in the MDD group. These findings might give evidence about abnormal FPN in MDD from the perspective of modular segregation in brain networks.
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Affiliation(s)
- Zhihui Lan
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Psychological Science, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China.,Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, China
| | - Wei Zhang
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Psychological Science, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Donglin Wang
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Psychological Science, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Zhonglin Tan
- Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Wang
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Psychological Science, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Chenyuan Pan
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Psychological Science, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China.,Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, China
| | - Yang Xiao
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Psychological Science, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China.,Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, China
| | - Changxiao Kuai
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Psychological Science, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China.,Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, China
| | - Shao-Wei Xue
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Institute of Psychological Science, Hangzhou Normal University, Hangzhou, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
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18
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Dini H, Sendi MSE, Sui J, Fu Z, Espinoza R, Narr KL, Qi S, Abbott CC, van Rooij SJH, Riva-Posse P, Bruni LE, Mayberg HS, Calhoun VD. Dynamic Functional Connectivity Predicts Treatment Response to Electroconvulsive Therapy in Major Depressive Disorder. Front Hum Neurosci 2021; 15:689488. [PMID: 34295231 PMCID: PMC8291148 DOI: 10.3389/fnhum.2021.689488] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/31/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Electroconvulsive therapy (ECT) is one of the most effective treatments for major depressive disorder. Recently, there has been increasing attention to evaluate the effect of ECT on resting-state functional magnetic resonance imaging (rs-fMRI). This study aims to compare rs-fMRI of depressive disorder (DEP) patients with healthy participants, investigate whether pre-ECT dynamic functional network connectivity network (dFNC) estimated from patients rs-fMRI is associated with an eventual ECT outcome, and explore the effect of ECT on brain network states. Method: Resting-state functional magnetic resonance imaging (fMRI) data were collected from 119 patients with depression or depressive disorder (DEP) (76 females), and 61 healthy (HC) participants (34 females), with an age mean of 52.25 (N = 180) years old. The pre-ECT and post-ECT Hamilton Depression Rating Scale (HDRS) were 25.59 ± 6.14 and 11.48 ± 9.07, respectively. Twenty-four independent components from default mode (DMN) and cognitive control network (CCN) were extracted, using group-independent component analysis from pre-ECT and post-ECT rs-fMRI. Then, the sliding window approach was used to estimate the pre-and post-ECT dFNC of each subject. Next, k-means clustering was separately applied to pre-ECT dFNC and post-ECT dFNC to assess three distinct states from each participant. We calculated the amount of time each subject spends in each state, which is called "occupancy rate" or OCR. Next, we compared OCR values between HC and DEP participants. We also calculated the partial correlation between pre-ECT OCRs and HDRS change while controlling for age, gender, and site. Finally, we evaluated the effectiveness of ECT by comparing pre- and post-ECT OCR of DEP and HC participants. Results: The main findings include (1) depressive disorder (DEP) patients had significantly lower OCR values than the HC group in state 2, where connectivity between cognitive control network (CCN) and default mode network (DMN) was relatively higher than other states (corrected p = 0.015), (2) Pre-ECT OCR of state, with more negative connectivity between CCN and DMN components, is linked with the HDRS changes (R = 0.23 corrected p = 0.03). This means that those DEP patients who spent less time in this state showed more HDRS change, and (3) The post-ECT OCR analysis suggested that ECT increased the amount of time DEP patients spent in state 2 (corrected p = 0.03). Conclusion: Our finding suggests that dynamic functional network connectivity (dFNC) features, estimated from CCN and DMN, show promise as a predictive biomarker of the ECT outcome of DEP patients. Also, this study identifies a possible underlying mechanism associated with the ECT effect on DEP patients.
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Affiliation(s)
- Hossein Dini
- Department of Architecture, Design and Media Technology, Aalborg University, Copenhagen, Denmark
| | - Mohammad S. E. Sendi
- Wallace H. Coulter Department of Biomedical Engineering at Georgia Institute of Technology and Emory University, Atlanta, GA, United States
- Department of Electrical and Computer Engineering at Georgia Institute of Technology, Atlanta, GA, United States
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia Institute of Technology, Georgia State University, Emory University, Atlanta, GA, United States
| | - Jing Sui
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia Institute of Technology, Georgia State University, Emory University, Atlanta, GA, United States
- National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Zening Fu
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia Institute of Technology, Georgia State University, Emory University, Atlanta, GA, United States
| | - Randall Espinoza
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Katherine L. Narr
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shile Qi
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia Institute of Technology, Georgia State University, Emory University, Atlanta, GA, United States
| | | | - Sanne J. H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Luis Emilio Bruni
- Department of Architecture, Design and Media Technology, Aalborg University, Copenhagen, Denmark
| | - Helen S. Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Vince D. Calhoun
- Wallace H. Coulter Department of Biomedical Engineering at Georgia Institute of Technology and Emory University, Atlanta, GA, United States
- Department of Electrical and Computer Engineering at Georgia Institute of Technology, Atlanta, GA, United States
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia Institute of Technology, Georgia State University, Emory University, Atlanta, GA, United States
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19
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Lemke H, Probst S, Warneke A, Waltemate L, Winter A, Thiel K, Meinert S, Enneking V, Breuer F, Klug M, Goltermann J, Hülsmann C, Grotegerd D, Redlich R, Dohm K, Leehr EJ, Repple J, Opel N, Brosch K, Meller T, Pfarr JK, Ringwald K, Schmitt S, Stein F, Krug A, Jansen A, Nenadic I, Kircher T, Hahn T, Dannlowski U. The Course of Disease in Major Depressive Disorder Is Associated With Altered Activity of the Limbic System During Negative Emotion Processing. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 7:323-332. [PMID: 34102346 DOI: 10.1016/j.bpsc.2021.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Brain functional alterations during emotion processing in patients with major depressive disorder (MDD) compared with healthy control subjects (HCs) are frequently reported. However, evidence for functional correlates of emotion processing with regard to MDD trajectories is scarce. This study investigates the role of lifetime disease course for limbic brain activation during negative emotional face processing in patients with MDD. METHODS In a large sample of patients with MDD (n = 333; 58.55% female) and HCs (n = 333; 60.06% female), brain activation was investigated during a negative emotional face-processing task within a cross-sectional design. Differences between HC and MDD groups were analyzed. Previous disease course, characterized by 2 components, namely hospitalization and duration of illness, was regressed on brain activation of the amygdala, (para-)hippocampus, and insula in patients with MDD. RESULTS Patients with MDD showed increased activation in the amygdala, insula, and hippocampus compared with HCs (all p values corrected for familywise error [pFWE] < .045). The hospitalization component showed negative associations with brain activation in the bilateral insula (right: pFWE = .026, left: pFWE = .019) and (para-)hippocampus (right: pFWE = .038, left: pFWE = .031). No significant association was found for the duration of illness component (all pFWE > .057). CONCLUSIONS This study investigated negative emotion processing in a large sample of patients with MDD and HCs. Our results confirm limbic hyperactivation in patients with MDD during negative emotion processing; however, this hyperactivation may resolve with a more severe lifetime disease course in the insula and (para-)hippocampus-brain regions involved in emotion processing and regulation. These findings need further replication in longitudinal studies.
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Affiliation(s)
- Hannah Lemke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Stefanie Probst
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Antonia Warneke
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lena Waltemate
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Thiel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Verena Enneking
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Fabian Breuer
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Melissa Klug
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Carina Hülsmann
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Ronny Redlich
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychology, University of Halle, Halle, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Münster, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | | | - Kai Ringwald
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany; Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Igor Nenadic
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.
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20
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Hartling C, Metz S, Pehrs C, Scheidegger M, Gruzman R, Keicher C, Wunder A, Weigand A, Grimm S. Comparison of Four fMRI Paradigms Probing Emotion Processing. Brain Sci 2021; 11:525. [PMID: 33919024 PMCID: PMC8142995 DOI: 10.3390/brainsci11050525] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/17/2021] [Accepted: 04/17/2021] [Indexed: 11/27/2022] Open
Abstract
Previous fMRI research has applied a variety of tasks to examine brain activity underlying emotion processing. While task characteristics are known to have a substantial influence on the elicited activations, direct comparisons of tasks that could guide study planning are scarce. We aimed to provide a comparison of four common emotion processing tasks based on the same analysis pipeline to suggest tasks best suited for the study of certain target brain regions. We studied an n-back task using emotional words (EMOBACK) as well as passive viewing tasks of emotional faces (FACES) and emotional scenes (OASIS and IAPS). We compared the activation patterns elicited by these tasks in four regions of interest (the amygdala, anterior insula, dorsolateral prefrontal cortex (dlPFC) and pregenual anterior cingulate cortex (pgACC)) in three samples of healthy adults (N = 45). The EMOBACK task elicited activation in the right dlPFC and bilateral anterior insula and deactivation in the pgACC while the FACES task recruited the bilateral amygdala. The IAPS and OASIS tasks showed similar activation patterns recruiting the bilateral amygdala and anterior insula. We conclude that these tasks can be used to study different regions involved in emotion processing and that the information provided is valuable for future research and the development of fMRI biomarkers.
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Affiliation(s)
- Corinna Hartling
- Department of Psychiatry and Psychotherapy, CBF, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany; (S.M.); (R.G.); (S.G.)
| | - Sophie Metz
- Department of Psychiatry and Psychotherapy, CBF, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany; (S.M.); (R.G.); (S.G.)
| | - Corinna Pehrs
- Bernstein Center for Computational Neuroscience, Humboldt-University Berlin, 10115 Berlin, Germany;
| | - Milan Scheidegger
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, 8032 Zurich, Switzerland;
| | - Rebecca Gruzman
- Department of Psychiatry and Psychotherapy, CBF, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany; (S.M.); (R.G.); (S.G.)
| | | | - Andreas Wunder
- Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharma GmbH and Co. KG, 52216 Ingelheim am Rhein, Germany;
| | - Anne Weigand
- Department of Psychology, Medical School Berlin, 14197 Berlin, Germany;
| | - Simone Grimm
- Department of Psychiatry and Psychotherapy, CBF, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany; (S.M.); (R.G.); (S.G.)
- Department of Psychology, Medical School Berlin, 14197 Berlin, Germany;
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