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Updated: Jan 7, 2026

Electroconvulsive Seizures in Rats and Fractionation of Their Hippocampi to Examine Seizure-induced Changes in Postsynaptic Density Proteins
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Electroconvulsive therapy is associated with a decrease in anhedonia and axial diffusivity in the medial forebrain

Ana Maria Rivas-Grajales1, Palig Mouradian2, George Papadimitriou2

  • 1Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.

Journal of Affective Disorders
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Electroconvulsive therapy (ECT) impacts the brain's reward pathways. Right unilateral ECT decreased axial diffusivity in the medial forebrain bundle, correlating with reduced depression and anhedonia.

Keywords:
AnhedoniaDiffusion tensor imagingElectroconvulsive therapyMajor depressive disorderMedial forebrain bundle

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Radiology

Background:

  • Electroconvulsive therapy (ECT) is a highly effective treatment for major depressive disorder (MDD).
  • The medial forebrain bundle (MFB), part of the mesocorticolimbic system, is implicated in mood regulation and reward.
  • Understanding ECT's effects on the MFB is crucial for elucidating its therapeutic mechanisms.

Purpose of the Study:

  • To investigate the impact of right unilateral ECT (RUL-ECT) on the MFB using diffusion-weighted imaging (DWI).
  • To explore the relationship between MFB structural changes and clinical outcomes in MDD patients, specifically depression severity and anhedonia.

Main Methods:

  • 11 MDD patients undergoing RUL-ECT were assessed using DWI.
  • The MFB was reconstructed via multi-tensor tractography.
  • Fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity (AD), and trace indices were compared pre- and post-ECT, alongside clinical measures (QIDS, SHAPS).

Main Results:

  • RUL-ECT significantly decreased AD in the right MFB.
  • Greater decreases in AD were strongly associated with improved depression severity.
  • AD reduction also correlated significantly with improvements in anhedonia.

Conclusions:

  • RUL-ECT induces right-lateralized white matter neuroplastic changes in the MFB, consistent with electrode placement.
  • MFB diffusion changes are linked to syndromic depression improvement and dimensional anhedonia reduction.
  • ECT's therapeutic effects may stem from targeted modulation of mood regulation and reward networks within the MFB.