e-Article
Effective resting-state connectivity in severe unipolar depression before and after electroconvulsive therapy.
Document Type
Academic Journal
Author
Ten Doesschate F; Department of Psychiatry, Rijnstate Hospital, Arnhem, the Netherlands; Amsterdam UMC Location University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands. Electronic address: FtenDoesschate@rijnstate.nl.; Bruin W; Amsterdam UMC Location University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands.; Zeidman P; Wellcome Centre for Human Neuroimaging, 12 Queen Square, London, WC1N 3AR, UK.; Abbott CC; Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM, USA.; Argyelan M; Center for Psychiatric Neuroscience at the Feinstein Institute for Medical Research, New York, NY, USA.; Dols A; GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, the Netherlands; Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, the Netherlands.; Emsell L; Katholieke Universiteit Leuven, University Psychiatric Center Katholieke Universiteit Leuven, Leuven, Belgium.; van Eijndhoven PFP; Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands; Department of Psychiatry, Radboud University Medical Centre, Huispost 961, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.; van Exel E; GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, the Netherlands; Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, the Netherlands.; Mulders PCR; Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands; Department of Psychiatry, Radboud University Medical Centre, Huispost 961, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.; Narr K; Departments of Neurology, Psychiatry, and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.; Tendolkar I; Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, the Netherlands; Department of Psychiatry, Radboud University Medical Centre, Huispost 961, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.; Rhebergen D; Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, the Netherlands; Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Neuroscience, the Netherlands.; Sienaert P; Academic Center for ECT and Neuromodulation (AcCENT), University Psychiatric Center KU Leuven (Catholic University of Leuven), Leuven, Belgium.; Vandenbulcke M; Katholieke Universiteit Leuven, University Psychiatric Center Katholieke Universiteit Leuven, Leuven, Belgium.; Verdijk J; Department of Psychiatry, Rijnstate Hospital, Arnhem, the Netherlands.; van Verseveld M; Department of Psychiatry, Rijnstate Hospital, Arnhem, the Netherlands.; Bartsch H; Mohn Medical Imaging and Visualization Center, Department of Radiology, Haukeland University Hospital, Bergen, Norway.; Oltedal L; Mohn Medical Imaging and Visualization Center, Department of Radiology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; van Waarde JA; Department of Psychiatry, Rijnstate Hospital, Arnhem, the Netherlands.; van Wingen GA; Amsterdam UMC Location University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands.
Source
Publisher: Elsevier Country of Publication: United States NLM ID: 101465726 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1876-4754 (Electronic) Linking ISSN: 18764754 NLM ISO Abbreviation: Brain Stimul Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Electroconvulsive therapy (ECT) is one of the most effective treatments for severe depressive disorders. A recent multi-center study found no consistent changes in correlation-based (undirected) resting-state connectivity after ECT. Effective (directed) connectivity may provide more insight into the working mechanism of ECT.
Objective: We investigated whether there are consistent changes in effective resting-state connectivity.
Methods: This multi-center study included data from 189 patients suffering from severe unipolar depression and 59 healthy control participants. Longitudinal data were available for 81 patients and 24 healthy controls. We used dynamic causal modeling for resting-state functional magnetic resonance imaging to determine effective connectivity in the default mode, salience and central executive networks before and after a course of ECT. Bayesian general linear models were used to examine differences in baseline and longitudinal effective connectivity effects associated with ECT and its effectiveness.
Results: Compared to controls, depressed patients showed many differences in effective connectivity at baseline, which varied according to the presence of psychotic features and later treatment outcome. Additionally, effective connectivity changed after ECT, which was related to ECT effectiveness. Notably, treatment effectiveness was associated with decreasing and increasing effective connectivity from the posterior default mode network to the left and right insula, respectively. No effects were found using correlation-based (undirected) connectivity.
Conclusions: A beneficial response to ECT may depend on how brain regions influence each other in networks important for emotion and cognition. These findings further elucidate the working mechanisms of ECT and may provide directions for future non-invasive brain stimulation research.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
Objective: We investigated whether there are consistent changes in effective resting-state connectivity.
Methods: This multi-center study included data from 189 patients suffering from severe unipolar depression and 59 healthy control participants. Longitudinal data were available for 81 patients and 24 healthy controls. We used dynamic causal modeling for resting-state functional magnetic resonance imaging to determine effective connectivity in the default mode, salience and central executive networks before and after a course of ECT. Bayesian general linear models were used to examine differences in baseline and longitudinal effective connectivity effects associated with ECT and its effectiveness.
Results: Compared to controls, depressed patients showed many differences in effective connectivity at baseline, which varied according to the presence of psychotic features and later treatment outcome. Additionally, effective connectivity changed after ECT, which was related to ECT effectiveness. Notably, treatment effectiveness was associated with decreasing and increasing effective connectivity from the posterior default mode network to the left and right insula, respectively. No effects were found using correlation-based (undirected) connectivity.
Conclusions: A beneficial response to ECT may depend on how brain regions influence each other in networks important for emotion and cognition. These findings further elucidate the working mechanisms of ECT and may provide directions for future non-invasive brain stimulation research.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)