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World J Psychiatry. Jan 19, 2022; 12(1): 128-139
Published online Jan 19, 2022. doi: 10.5498/wjp.v12.i1.128
Current progress in neuroimaging research for the treatment of major depression with electroconvulsive therapy
Xin-Ke Li, Hai-Tang Qiu
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
Author contributions: Li XK and Qiu HT developed the framework of the paper; Li XK wrote the first draft; all authors worked in subsequent drafts, confirmed the last version before submission, and approved the final manuscript.
Supported by the Natural Science Foundation of China, No. 81901373.
Conflict-of-interest statement: The authors have no conflicts of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Xin-Ke Li, PhD, Associate Professor, Postdoc, College of Medical Informatics, Chongqing Medical University, No. 1 Medical School Road, Yuzhong District, Chongqing 400016, China.
Received: April 1, 2021
Peer-review started: April 1, 2021
First decision: June 5, 2021
Revised: June 20, 2021
Accepted: September 6, 2021
Article in press: September 6, 2021
Published online: January 19, 2022

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.

Keywords: Neuroimaging, Major depression, Electroconvulsive therapy, Magnetic resonance imaging, Positron emission tomography, Magnetic resonance spectroscopy

Core tip: Longitudinal neuroimaging studies in patients with major depression before and after electroconvulsive therapy (ECT) have shown that ECT has effects on specific brain areas. However, these ECT-regulated brain regions and their changes are uncertain. Based on recent studies with various neuroimaging techniques, this paper reviews longitudinal neuroimaging findings in recent years and discusses the relatively consistent results.