电休克疗法可调节重度抑郁症患者大脑连接组的动态变化。

IF 9.6 1区医学 Q1 NEUROSCIENCES

Biological Psychiatry Pub Date : 2024-03-21 DOI:10.1016/j.biopsych.2024.03.012

Yuanyuan Guo , Mingrui Xia , Rong Ye , Tongjian Bai , Yue Wu , Yang Ji , Yue Yu , Gong-Jun Ji , Kai Wang , Yong He , Yanghua Tian

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引用次数: 0

摘要

背景：电休克疗法（ECT）是治疗重度抑郁症（MDD）患者的一种有效方法，但其潜在的神经机制在很大程度上仍不为人所知。本研究旨在确定重度抑郁症患者接受电休克治疗后大脑连接组动态的变化，并探讨其与治疗结果的关联：我们收集了ECT前后80名MDD患者（50名有自杀意念，30名无自杀意念；分别为SI和NSI）和37名年龄和性别匹配的健康对照者的纵向静息态fMRI数据。研究人员使用多层网络模型来评估功能连接组随时间变化的模块切换。支持向量回归用于评估ECT前的网络动态是否能预测症状严重程度的治疗反应：基线时，与对照组相比，MDD 患者的功能连接组的全局模块化程度较低，模块变异性较高。ECT治疗后，MDD患者的网络模块化程度增加，网络变异性降低，主要集中在默认模式和躯体运动网络。此外，ECT与MDD-SI患者左侧背侧前扣带回皮层模块变异性的降低有关，但与MDD-NSI患者无关，ECT前模块变异性可显著预测MDD-SI组症状的改善，但不能预测MDD-NSI组症状的改善：我们强调了ECT诱导的MDD大脑网络动态变化及其对治疗结果的预测价值，尤其是在有自杀意念的患者中。这项研究从动态脑网络的角度推进了我们对ECT神经机制的理解，并提出了预测ECT对MDD患者疗效的潜在预后生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Electroconvulsive Therapy Regulates Brain Connectome Dynamics in Patients With Major Depressive Disorder

Background

Electroconvulsive therapy (ECT) is an effective treatment for patients with major depressive disorder (MDD), but its underlying neural mechanisms remain largely unknown. The aim of this study was to identify changes in brain connectome dynamics after ECT in MDD and to explore their associations with treatment outcome.

Methods

We collected longitudinal resting-state functional magnetic resonance imaging data from 80 patients with MDD (50 with suicidal ideation [MDD-SI] and 30 without [MDD-NSI]) before and after ECT and 37 age- and sex-matched healthy control participants. A multilayer network model was used to assess modular switching over time in functional connectomes. Support vector regression was used to assess whether pre-ECT network dynamics could predict treatment response in terms of symptom severity.

Results

At baseline, patients with MDD had lower global modularity and higher modular variability in functional connectomes than control participants. Network modularity increased and network variability decreased after ECT in patients with MDD, predominantly in the default mode and somatomotor networks. Moreover, ECT was associated with decreased modular variability in the left dorsal anterior cingulate cortex of MDD-SI but not MDD-NSI patients, and pre-ECT modular variability significantly predicted symptom improvement in the MDD-SI group but not in the MDD-NSI group.

Conclusions

We highlight ECT-induced changes in MDD brain network dynamics and their predictive value for treatment outcome, particularly in patients with SI. This study advances our understanding of the neural mechanisms of ECT from a dynamic brain network perspective and suggests potential prognostic biomarkers for predicting ECT efficacy in patients with MDD.

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来源期刊

Biological Psychiatry 医学-精神病学

CiteScore

18.80

自引率

2.80%

发文量

1398

审稿时长

33 days

期刊介绍： Biological Psychiatry is an official journal of the Society of Biological Psychiatry and was established in 1969. It is the first journal in the Biological Psychiatry family, which also includes Biological Psychiatry: Cognitive Neuroscience and Neuroimaging and Biological Psychiatry: Global Open Science. The Society's main goal is to promote excellence in scientific research and education in the fields related to the nature, causes, mechanisms, and treatments of disorders pertaining to thought, emotion, and behavior. To fulfill this mission, Biological Psychiatry publishes peer-reviewed, rapid-publication articles that present new findings from original basic, translational, and clinical mechanistic research, ultimately advancing our understanding of psychiatric disorders and their treatment. The journal also encourages the submission of reviews and commentaries on current research and topics of interest.