TY - JOUR

T1 - Effect of electroconvulsive therapy on neural response to affective pictures

T2 - A randomized, sham-controlled fMRI study

AU - Miskowiak, Kamilla Woznica

AU - Macoveanu, Julian

AU - Jørgensen, Merete Barker

AU - Ott, Caroline Vintergaard

AU - Støttrup, M M

AU - Jensen, Hannah Malene

AU - Jørgensen, A

AU - Harmer, Catherine J

AU - Paulson, Olaf B.

AU - Siebner, Hartwig Roman

AU - Kessing, Lars Vedel

N1 - Copyright © 2018. Published by Elsevier B.V.

PY - 2018/8

Y1 - 2018/8

N2 - Electroconvulsive therapy (ECT) is the most effective treatment for severe depression but its neurocognitive mechanisms are unclear. This randomized, sham-controlled functional magnetic resonance imaging (fMRI) study explored the effects of a single ECT on neural response to affective pictures. Twenty-seven patients with major depressive disorder were randomized to a single active ECT (N = 15) or sham (N = 12) session in a double-blind, parallel-group design. On the following day, patients underwent fMRI during which they viewed pleasant, unpleasant and neutral pictures and performed a free recall test after the scan. Mood symptoms were assessed before ECT/sham and at the time of fMRI. Subsequently, all patients continued active ECT as usual. Mood symptoms were reassessed after six active ECT sessions. A single ECT vs. sham session reduced neural response to unpleasant vs. pleasant pictures in the medial prefrontal cortex, a region showing greater response in the more depressed patients. This effect occurred in the absence of between-group differences in picture recall, mood symptoms or concomitant medication. In conclusion, modulation of medial prefrontal hyper-activity during encoding of negative affective information may be a common mechanism of distinct biological depression treatments.

AB - Electroconvulsive therapy (ECT) is the most effective treatment for severe depression but its neurocognitive mechanisms are unclear. This randomized, sham-controlled functional magnetic resonance imaging (fMRI) study explored the effects of a single ECT on neural response to affective pictures. Twenty-seven patients with major depressive disorder were randomized to a single active ECT (N = 15) or sham (N = 12) session in a double-blind, parallel-group design. On the following day, patients underwent fMRI during which they viewed pleasant, unpleasant and neutral pictures and performed a free recall test after the scan. Mood symptoms were assessed before ECT/sham and at the time of fMRI. Subsequently, all patients continued active ECT as usual. Mood symptoms were reassessed after six active ECT sessions. A single ECT vs. sham session reduced neural response to unpleasant vs. pleasant pictures in the medial prefrontal cortex, a region showing greater response in the more depressed patients. This effect occurred in the absence of between-group differences in picture recall, mood symptoms or concomitant medication. In conclusion, modulation of medial prefrontal hyper-activity during encoding of negative affective information may be a common mechanism of distinct biological depression treatments.

KW - Depression

KW - ECT

KW - Magnetic resonance imaging

KW - Neurocognition

KW - Prefrontal cortex

U2 - 10.1016/j.euroneuro.2018.05.013

DO - 10.1016/j.euroneuro.2018.05.013

M3 - Journal article

C2 - 29891215

VL - 28

SP - 915

EP - 924

JO - European Neuropsychopharmacology

JF - European Neuropsychopharmacology

SN - 0924-977X

IS - 8

ER -