Observational Study
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World J Psychiatry. May 19, 2022; 12(5): 708-721
Published online May 19, 2022. doi: 10.5498/wjp.v12.i5.708
Changes in the amplitude of low-frequency fluctuations in specific frequency bands in major depressive disorder after electroconvulsive therapy
Xin-Ke Li, Hai-Tang Qiu, Jia Hu, Qing-Hua Luo
Xin-Ke Li, College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
Hai-Tang Qiu, Qing-Hua Luo, Mental Health Center, the First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing 400016, China
Jia Hu, Institute for Advanced Studies in Humanities and Social Science, Chongqing University, Chongqing 400044, China
Author contributions: Li XK conducted the statistical analysis and wrote the manuscript; Qiu HT performed the study design and interpretation of findings; Luo QH recruited the patients, collected the data; Hu J revised the manuscript.
Supported by the Natural Science Foundation of China, No. 81901373; and the Intelligent Medicine Research Project of Chongqing Medical University, No. ZHYX202126.
Institutional review board statement: The study was reviewed and approved by the (the local ethics committee of Chongqing Medical University) Institutional Review Board (Approval No. 2020-97-2).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors have no conflict interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Ke Li, PhD, Associate Professor, College of Medical Informatics, Chongqing Medical University, No. 1 Medical School Road, Chongqing 400016, China. lixinke@cqmu.edu.cn
Received: December 22, 2021
Peer-review started: December 22, 2021
First decision: March 13, 2022
Revised: March 26, 2022
Accepted: April 21, 2022
Article in press: April 21, 2022
Published online: May 19, 2022
Processing time: 146 Days and 15.8 Hours
Abstract
BACKGROUND

Major depressive disorder (MDD) tends to have a high incidence and high suicide risk. Electroconvulsive therapy (ECT) is currently a relatively effective treatment for MDD. However, the mechanism of efficacy of ECT is still unclear.

AIM

To investigate the changes in the amplitude of low-frequency fluctuations in specific frequency bands in patients with MDD after ECT.

METHODS

Twenty-two MDD patients and fifteen healthy controls (HCs) were recruited to this study. MDD patients received 8 ECT sessions with bitemporal placement. Resting-state functional magnetic resonance imaging was adopted to examine regional cerebellar blood flow in both the MDD patients and HCs. The MDD patients were scanned twice (before the first ECT session and after the eighth ECT session) to acquire data. Then, the amplitude of low-frequency fluctuations (ALFF) was computed to characterize the intrinsic neural oscillations in different bands (typical frequency, slow-5, and slow-4 bands).

RESULTS

Compared to before ECT (pre-ECT), we found that MDD patients after the eighth ECT (post-ECT) session had a higher ALFF in the typical band in the right middle frontal gyrus, posterior cingulate, right supramarginal gyrus, left superior frontal gyrus, and left angular gyrus. There was a lower ALFF in the right superior temporal gyrus. Compared to pre-ECT values, the ALFF in the slow-5 band was significantly increased in the right limbic lobe, cerebellum posterior lobe, right middle orbitofrontal gyrus, and frontal lobe in post-ECT patients, whereas the ALFF in the slow-5 band in the left sublobar region, right angular gyrus, and right frontal lobe was lower. In contrast, significantly higher ALFF in the slow-4 band was observed in the frontal lobe, superior frontal gyrus, parietal lobe, right inferior parietal lobule, and left angular gyrus.

CONCLUSION

Our results suggest that the abnormal ALFF in pre- and post-ECT MDD patients may be associated with specific frequency bands.

Keywords: Electroconvulsive therapy; Resting-state functional magnetic resonance imaging; Major depressive disorder; Amplitude of low-frequency fluctuations; Specific frequency bands

Core Tip: In this study, we explored changes in the intrinsic neural activity in major depressive disorder (MDD) patients who underwent electroconvulsive therapy (ECT) procedures by calculating amplitude of low-frequency fluctuations (ALFF) values for different bands. Compared to pre-ECT values, the ALFF in the slow-5 band was significantly increased in the right limbic lobe, cerebellum posterior lobe, right middle orbitofrontal gyrus, and frontal lobe in post-ECT patients, whereas the ALFF in the slow-5 band in the left sublobar region, right angular gyrus, and right frontal lobe was lower. In contrast, significantly higher ALFF in the slow-4 band was observed in the frontal lobe, superior frontal gyrus, parietal lobe, right inferior parietal lobule, and left angular gyrus. Our findings demonstrated that the ALFF alterations in post-ECT patients are dependent on specific frequency bands. These results may help us to understand more fully the potential therapeutic mechanisms of ECT for MDD patients.