Postictal resting-state connectivity changes after electroconvulsive therapy-induced seizures

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Electroconvulsive therapy (ECT) is used for major depression but causes temporary brain function changes.
• The immediate effects of ECT-induced seizures on brain networks are not well understood.
• Resting-state networks (RSNs) offer insights into brain connectivity.

Purpose of the Study:

• To investigate brain-wide RSN connectivity changes in the immediate postictal state after ECT.
• To analyze alterations in RSN connectivity strength shortly following ECT-induced seizures.

Main Methods:

• Analyzed resting-state functional magnetic resonance imaging (fMRI) data from 17 major depression patients before and after ECT.
• Compared patient data to 27 healthy controls to assess test-retest effects.
• Measured clinical recovery using the reorientation time questionnaire.

Main Results:

• Postictal decreases in mean connectivity strength were observed in the left central executive network and auditory network.
• Voxel-wise analyses revealed increased salience network connectivity with cerebellar regions.
• Decreased within-network connectivity was noted in the default mode network and left central executive network.
• No significant associations were found between network changes and clinical recovery.

Conclusions:

• ECT-induced seizures are followed by immediate postictal decreases in left central executive and auditory network connectivity.
• Increased salience network connectivity with the cerebellum and decreased default mode network connectivity were observed.
• These acute network changes post-ECT do not correlate with immediate clinical recovery.