Electroconvulsive therapy modulates brain functional stability in patients with major depressive disorder

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Electroconvulsive therapy (ECT) is a highly effective treatment for major depressive disorder (MDD).
• The precise neuromodulatory mechanisms underlying ECT's efficacy are not fully understood.
• Functional stability, a novel metric derived from dynamic functional connectivity, offers a new lens to examine brain network dynamics.

Purpose of the Study:

• To investigate ECT-induced alterations in whole-brain functional stability in MDD patients.
• To explore the relationship between changes in functional stability and clinical outcomes following ECT.
• To identify potential neuroimaging biomarkers for predicting ECT response in MDD.

Main Methods:

• Longitudinal resting-state functional magnetic resonance imaging (fMRI) data were acquired from 58 MDD patients and 42 healthy controls.
• Voxel-level whole-brain functional stability analysis was performed to assess neural changes.
• Patients were categorized into remitters (n=39) and non-remitters (n=19) based on their response to ECT.

Main Results:

• Following ECT, MDD patients exhibited increased functional stability in the bilateral middle frontal gyrus and angular gyrus.
• A decrease in functional stability was observed in the right fusiform gyrus post-ECT.
• Subgroup analysis revealed differential hippocampal functional stability changes: a decrease in remitters and an increase in non-remitters.

Conclusions:

• ECT significantly modulates brain functional stability in MDD patients.
• Differential changes in functional stability, especially in the hippocampus, distinguish between ECT responders and non-responders.
• Functional stability shows promise as a prognostic biomarker for monitoring ECT efficacy and guiding personalized treatment strategies in MDD.