Functional and structural alterations in the pain‐related circuit in major depressive disorder induced by electroconvulsive therapy

电休克疗法 重性抑郁障碍 扁桃形结构 脑岛 扣带回前部 心理学 神经科学 神经影像学 大脑结构与功能 医学 认知
作者
Ting Zhang,Qiangqiang Hou,Tongjian Bai,Gong‐Jun Ji,Huaming Lv,Wen Xie,Shengchun Jin,Jinying Yang,Bensheng Qiu,Yanghua Tian,Kai Wang
出处
期刊:Journal of Neuroscience Research [Wiley]
卷期号:100 (2): 477-489 被引量:5
标识
DOI:10.1002/jnr.24979
摘要

Approximately two-thirds of major depressive disorder (MDD) patients have pain, which exacerbates the severity of depression. Electroconvulsive therapy (ECT) is an efficacious treatment that can alleviate depressive symptoms; however, treatment for pain and the underlying neural substrate is elusive. We enrolled 34 patients with MDD and 33 matched healthy controls to complete clinical assessments and neuroimaging scans. MDD patients underwent second assessments and scans after ECT. We defined a pain-related network with a published meta-analysis and calculated topological patterns to reveal topologic alterations induced by ECT. Using the amplitude of low-frequency fluctuations (ALFFs), we probed local function aberrations of pain-related circuits in MDD patients. Subsequently, we applied gray matter volume (GMV) to reveal structural alterations of ECT relieving pain. The relationships between functional and structural aberrations and pain were determined. ECT significantly alleviated pain. The neural mechanism based on pain-related circuits indicated that ECT weakened the circuit function (ALFF: left amygdala and right supplementary motor area), while augmenting the structure (GMV: bilateral amygdala/insula/hippocampus and anterior cingulate cortex). The topologic patterns became less efficient after ECT. Correlation analysis between the change in pain and GMV had negative results in bilateral amygdala/insula/hippocampus. Similarity, there was a positive correlation between a change in ALFF in the left amygdala and improved clinical symptoms. ECT improved pain by decreasing brain local function and global network patterns, while increasing structure in pain-related circuits. Functional and structural alterations were associated with improvement in pain.
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