TY - JOUR
T1 - Effect of electroconvulsive therapy on neural response to affective pictures
T2 - A randomized, sham-controlled fMRI study
AU - Miskowiak, Kamilla Woznica
AU - Macoveanu, Julian
AU - Jørgensen, Merete Barker
AU - Ott, Caroline Vintergaard
AU - Støttrup, M M
AU - Jensen, Hannah Malene
AU - Jørgensen, A
AU - Harmer, Catherine J
AU - Paulson, Olaf B.
AU - Siebner, Hartwig Roman
AU - Kessing, Lars Vedel
N1 - Copyright © 2018. Published by Elsevier B.V.
PY - 2018/8
Y1 - 2018/8
N2 - Electroconvulsive therapy (ECT) is the most effective treatment for severe depression but its neurocognitive mechanisms are unclear. This randomized, sham-controlled functional magnetic resonance imaging (fMRI) study explored the effects of a single ECT on neural response to affective pictures. Twenty-seven patients with major depressive disorder were randomized to a single active ECT (N = 15) or sham (N = 12) session in a double-blind, parallel-group design. On the following day, patients underwent fMRI during which they viewed pleasant, unpleasant and neutral pictures and performed a free recall test after the scan. Mood symptoms were assessed before ECT/sham and at the time of fMRI. Subsequently, all patients continued active ECT as usual. Mood symptoms were reassessed after six active ECT sessions. A single ECT vs. sham session reduced neural response to unpleasant vs. pleasant pictures in the medial prefrontal cortex, a region showing greater response in the more depressed patients. This effect occurred in the absence of between-group differences in picture recall, mood symptoms or concomitant medication. In conclusion, modulation of medial prefrontal hyper-activity during encoding of negative affective information may be a common mechanism of distinct biological depression treatments.
AB - Electroconvulsive therapy (ECT) is the most effective treatment for severe depression but its neurocognitive mechanisms are unclear. This randomized, sham-controlled functional magnetic resonance imaging (fMRI) study explored the effects of a single ECT on neural response to affective pictures. Twenty-seven patients with major depressive disorder were randomized to a single active ECT (N = 15) or sham (N = 12) session in a double-blind, parallel-group design. On the following day, patients underwent fMRI during which they viewed pleasant, unpleasant and neutral pictures and performed a free recall test after the scan. Mood symptoms were assessed before ECT/sham and at the time of fMRI. Subsequently, all patients continued active ECT as usual. Mood symptoms were reassessed after six active ECT sessions. A single ECT vs. sham session reduced neural response to unpleasant vs. pleasant pictures in the medial prefrontal cortex, a region showing greater response in the more depressed patients. This effect occurred in the absence of between-group differences in picture recall, mood symptoms or concomitant medication. In conclusion, modulation of medial prefrontal hyper-activity during encoding of negative affective information may be a common mechanism of distinct biological depression treatments.
KW - Depression
KW - ECT
KW - Magnetic resonance imaging
KW - Neurocognition
KW - Prefrontal cortex
U2 - 10.1016/j.euroneuro.2018.05.013
DO - 10.1016/j.euroneuro.2018.05.013
M3 - Journal article
C2 - 29891215
SN - 0924-977X
VL - 28
SP - 915
EP - 924
JO - European Neuropsychopharmacology
JF - European Neuropsychopharmacology
IS - 8
ER -