Cerebral perfusion is related to antidepressant effect and cognitive side effects of Electroconvulsive Therapy
Background: The mechanisms underlying the antidepressant effect and cognitive side effects of Electroconvulsive Therapy (ECT) remain elusive. The measurement of cerebral perfusion provides an insight into brain physiology. Objective: We investigated ECT-related perfusion changes in depressed patient...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | Brain Stimulation |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1935861X22002303 |
| _version_ | 1797978767764750336 |
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| author | Krzysztof Gbyl Ulrich Lindberg Henrik Bo Wiberg Larsson Egill Rostrup Poul Videbech |
| author_facet | Krzysztof Gbyl Ulrich Lindberg Henrik Bo Wiberg Larsson Egill Rostrup Poul Videbech |
| author_sort | Krzysztof Gbyl |
| collection | DOAJ |
| description | Background: The mechanisms underlying the antidepressant effect and cognitive side effects of Electroconvulsive Therapy (ECT) remain elusive. The measurement of cerebral perfusion provides an insight into brain physiology. Objective: We investigated ECT-related perfusion changes in depressed patients and tested whether these changes correlate with clinical effects. Methods: A sample of 22 in-patients was examined at three time points: 1) within two days before, 2) within one week after, and 3) six months after an ECT series. Cerebral perfusion was quantified using arterial spin labeling magnetic resonance imaging. The primary regions of interest were the bilateral dorsolateral prefrontal cortices (DL-PFC) and hippocampi. The depression severity was assessed by the six-item Hamilton Depression Rating Scale, and cognitive performance by the Screen for Cognitive Impairment in Psychiatry. A linear mixed model and partial correlation were used for statistical analyses. Results: Following an ECT series, perfusion decreased in the right (−6.0%, p = .01) and left DL-PFC (−5.6%, p = .001). Perfusion increased in the left hippocampus (4.8%, p = .03), while on the right side the increase was insignificant (2.3%, p = .23). A larger perfusion reduction in the right DL-PFC correlated with a better antidepressant effect, and a larger perfusion increase in the right hippocampus with worse cognitive impairment. Conclusion: ECT-induced attenuation of prefrontal activity may be related to clinical improvement, whereas a hippocampal process triggered by the treatment is likely associated with cognitive side effects. |
| first_indexed | 2024-04-11T05:28:15Z |
| format | Article |
| id | doaj.art-7b805cce27f64cf0970706027228fbe4 |
| institution | Directory Open Access Journal |
| issn | 1935-861X |
| language | English |
| last_indexed | 2024-04-11T05:28:15Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain Stimulation |
| spelling | doaj.art-7b805cce27f64cf0970706027228fbe42022-12-23T04:40:29ZengElsevierBrain Stimulation1935-861X2022-11-0115614861494Cerebral perfusion is related to antidepressant effect and cognitive side effects of Electroconvulsive TherapyKrzysztof Gbyl0Ulrich Lindberg1Henrik Bo Wiberg Larsson2Egill Rostrup3Poul Videbech4Center for Neuropsychiatric Depression Research (CNDR), Mental Health Center Glostrup, Glostrup, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Corresponding author. Center for Neuropsychiatric Depression Research, Mental Health Center Glostrup, Nordstjernevej 41, 2600, Glostrup, Denmark.Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical Physiology and Nuclear Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkCenter for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, DenmarkCenter for Neuropsychiatric Depression Research (CNDR), Mental Health Center Glostrup, Glostrup, Denmark; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkBackground: The mechanisms underlying the antidepressant effect and cognitive side effects of Electroconvulsive Therapy (ECT) remain elusive. The measurement of cerebral perfusion provides an insight into brain physiology. Objective: We investigated ECT-related perfusion changes in depressed patients and tested whether these changes correlate with clinical effects. Methods: A sample of 22 in-patients was examined at three time points: 1) within two days before, 2) within one week after, and 3) six months after an ECT series. Cerebral perfusion was quantified using arterial spin labeling magnetic resonance imaging. The primary regions of interest were the bilateral dorsolateral prefrontal cortices (DL-PFC) and hippocampi. The depression severity was assessed by the six-item Hamilton Depression Rating Scale, and cognitive performance by the Screen for Cognitive Impairment in Psychiatry. A linear mixed model and partial correlation were used for statistical analyses. Results: Following an ECT series, perfusion decreased in the right (−6.0%, p = .01) and left DL-PFC (−5.6%, p = .001). Perfusion increased in the left hippocampus (4.8%, p = .03), while on the right side the increase was insignificant (2.3%, p = .23). A larger perfusion reduction in the right DL-PFC correlated with a better antidepressant effect, and a larger perfusion increase in the right hippocampus with worse cognitive impairment. Conclusion: ECT-induced attenuation of prefrontal activity may be related to clinical improvement, whereas a hippocampal process triggered by the treatment is likely associated with cognitive side effects.http://www.sciencedirect.com/science/article/pii/S1935861X22002303Electroconvulsive therapyMajor depressive disorderDepressionCerebral blood flowCerebral perfusionFunctional MRI |
| spellingShingle | Krzysztof Gbyl Ulrich Lindberg Henrik Bo Wiberg Larsson Egill Rostrup Poul Videbech Cerebral perfusion is related to antidepressant effect and cognitive side effects of Electroconvulsive Therapy Brain Stimulation Electroconvulsive therapy Major depressive disorder Depression Cerebral blood flow Cerebral perfusion Functional MRI |
| title | Cerebral perfusion is related to antidepressant effect and cognitive side effects of Electroconvulsive Therapy |
| title_full | Cerebral perfusion is related to antidepressant effect and cognitive side effects of Electroconvulsive Therapy |
| title_fullStr | Cerebral perfusion is related to antidepressant effect and cognitive side effects of Electroconvulsive Therapy |
| title_full_unstemmed | Cerebral perfusion is related to antidepressant effect and cognitive side effects of Electroconvulsive Therapy |
| title_short | Cerebral perfusion is related to antidepressant effect and cognitive side effects of Electroconvulsive Therapy |
| title_sort | cerebral perfusion is related to antidepressant effect and cognitive side effects of electroconvulsive therapy |
| topic | Electroconvulsive therapy Major depressive disorder Depression Cerebral blood flow Cerebral perfusion Functional MRI |
| url | http://www.sciencedirect.com/science/article/pii/S1935861X22002303 |
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