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Proc Natl Acad Sci U S A. 2014 Jan 21;111(3):1156-61. doi: 10.1073/pnas.1321399111. Epub 2013 Dec 30.

Electroconvulsive therapy-induced brain plasticity determines therapeutic outcome in mood disorders.

Author information

1
Laboratoire de Recherche en Neuroimagerie, Département des Neurosciences Cliniques-Centre Hospitalier Universitaire Vaudois, Université de Lausanne, 1011 Lausanne, Switzerland.

Abstract

There remains much scientific, clinical, and ethical controversy concerning the use of electroconvulsive therapy (ECT) for psychiatric disorders stemming from a lack of information and knowledge about how such treatment might work, given its nonspecific and spatially unfocused nature. The mode of action of ECT has even been ascribed to a "barbaric" form of placebo effect. Here we show differential, highly specific, spatially distributed effects of ECT on regional brain structure in two populations: patients with unipolar or bipolar disorder. Unipolar and bipolar disorders respond differentially to ECT and the associated local brain-volume changes, which occur in areas previously associated with these diseases, correlate with symptom severity and the therapeutic effect. Our unique evidence shows that electrophysical therapeutic effects, although applied generally, take on regional significance through interactions with brain pathophysiology.

KEYWORDS:

hippocampus; magnetic resonance imaging; unipolar depression; voxel-based morphometry

PMID:
24379394
PMCID:
PMC3903198
DOI:
10.1073/pnas.1321399111
[Indexed for MEDLINE]
Free PMC Article
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