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Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder

Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder

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Authors

  • Jennifer S. Perrin
  • Susanne Merz
  • Daniel M. Bennett
  • James Currie
  • Douglas J. Steele
  • Ian C. Reid
  • Christian Schwarzbauer

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Info

Original languageEnglish
Pages5464-5468
Number of pages5
JournalProceedings of the National Academy of Sciences of the United States of America
Journal publication date3 Apr 2012
Journal number14
Volume109
DOIs
StatePublished

Abstract

To date, electroconvulsive therapy (ECT) is the most potent treatment in severe depression. Although ECT has been successfully applied in clinical practice for over 70 years, the underlying mechanisms of action remain unclear. We used functional MRI and a unique data-driven analysis approach to examine functional connectivity in the brain before and after ECT treatment. Our results show that ECT has lasting effects on the functional architecture of the brain. A comparison of pre- and posttreatment functional connectivity data in a group of nine patients revealed a significant cluster of voxels in and around the left dorsolateral prefrontal cortical region (Brodmann areas 44, 45, and 46), where the average global functional connectivity was considerably decreased after ECT treatment (P < 0.05, family-wise error-corrected). This decrease in functional connectivity was accompanied by a significant improvement (P < 0.001) in depressive symptoms; the patients' mean scores on the Montgomery Asberg Depression Rating Scale pre- and posttreatment were 36.4 (SD = 4.9) and 10.7 (SD = 9.6), respectively. The findings reported here add weight to the emerging "hyperconnectivity hypothesis" in depression and support the proposal that increased connectivity may constitute both a bio-marker for mood disorder and a potential therapeutic target.

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