Electroconvulsive therapy-induced neuroimaging alterations measured by cerebral blood flow in adolescents with major depressive disorder

Ren-Qiang Yu; Zhu-Jun Zhang; Rong-Sheng Chen; Xing-Yu Wang; Xiao Li; Lin-Qi Dai; Zhen-Lin Li

doi:10.1016/j.jad.2023.02.027

Electroconvulsive therapy-induced neuroimaging alterations measured by cerebral blood flow in adolescents with major depressive disorder

J Affect Disord. 2023 Apr 14:327:385-390. doi: 10.1016/j.jad.2023.02.027. Epub 2023 Feb 8.

Authors

Ren-Qiang Yu¹, Zhu-Jun Zhang², Rong-Sheng Chen³, Xing-Yu Wang³, Xiao Li⁴, Lin-Qi Dai⁴, Zhen-Lin Li⁵

Affiliations

¹ Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
² Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
³ Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
⁴ Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
⁵ Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China. Electronic address: HX_lizhenlin@126.com.

PMID: 36758871
DOI: 10.1016/j.jad.2023.02.027

Abstract

Background: Electroconvulsive therapy (ECT) is a novel treatment strategy for adolescents with major depressive disorder (MDD). However, its related neurobiological changes associated with ECT remain undetermined.

Objective: To elucidate the impact of ECT on the regional cerebral blood flow (CBF), and to identify alterations in the CBF associated with clinical outcomes in adolescents with MDD.

Methods: Fifty-two treatment-naive adolescents who had experienced their first episode of MDD and 36 healthy controls (HCs) were recruited. To assess baseline parameters, all subjects were scanned with arterial spin labeling resting-state functional magnetic resonance imaging (ASL-fMRI) at the beginning of the study. Subsequently, 27 MDD adolescents were re-scanned after 2 weeks after ECT. CBF imaging was used for the prediction of specific clinical outcomes. Lastly, the associations between alterations seen on brain imaging alterations after ECT and ECT clinical efficacy (ΔHAMD scores) were determined.

Results: Relative to HCs, adolescents with MDD exhibited reduced CBF in the left medial superior frontal gyrus (SFGmed) (cluster = 243, peak t = -3.9373, and P < 0.001) and augmented CBF in the right percental gyrus (PerCG) (cluster = 321, peak t = 4.3332, and P < 0.001) at baseline. Following ECT, MDD adolescents exhibited reduced CBF in the right fusiform gyrus (FFG) (cluster = 309, peak t = -4.346, and P < 0.001) and left hippocampus (HIP) (cluster = 290, peak t = -4.706, and P < 0.001), and enhanced CBF in the left orbital part of the inferior frontal gyrus (ORBinf) (cluster = 214, peak t = 4.073, and P < 0.001). Correlation analysis suggested an inverse association between ΔHAMD scores and CBF values in the left ORBinf (R² = 0.196, P = 0.021).

Conclusions: It was found that ECT resulted in alterations in CBF in specific brain areas, highlighting the significance of ORBinf in ECT pathophysiology in MDD adolescents.

Keywords: Adolescent; Arterial spin labeling; Cerebral blood flow; Electroconvulsive therapy; Major depressive disorder; Resting-state fMRI.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Brain
Cerebrovascular Circulation
Depressive Disorder, Major*
Electroconvulsive Therapy* / methods
Humans
Magnetic Resonance Imaging / methods
Neuroimaging