Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder

Jennifer Perrin (Corresponding Author), Susanne Merz, Daniel Mark Bennett, James Currie, Douglas Steele, Ian Cameron Reid, Christian Schwarzbauer

Research output: Contribution to journalArticle

136 Citations (Scopus)

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 biomarker for mood disorder and a potential therapeutic target.

Original languageEnglish
Pages (from-to)5464-5468
Number of pages5
JournalPNAS
Volume109
Issue number14
Early online date19 Mar 2012
DOIs
Publication statusPublished - 3 Apr 2012

Keywords

  • mental health
  • neuroimaging
  • antidepressant
  • cognitive function

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