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Psychol Med. 2017 Sep;47(12):2166-2176. doi: 10.1017/S0033291717000605. Epub 2017 Apr 11.

Effects of electroconvulsive therapy on amygdala function in major depression - a longitudinal functional magnetic resonance imaging study.

Author information

1
Department of Psychiatry,University of Münster,Münster,Germany.
2
Department of Psychiatry,University of Marburg,Marburg,Germany.
3
Department of Clinical Radiology,University of Münster,Münster,Germany.

Abstract

BACKGROUND:

Electroconvulsive therapy (ECT) is one of the most effective treatments for severe depression. However, little is known regarding brain functional processes mediating ECT effects.

METHOD:

In a non-randomized prospective study, functional magnetic resonance imaging data during the automatic processing of subliminally presented emotional faces were obtained twice, about 6 weeks apart, in patients with major depressive disorder (MDD) before and after treatment with ECT (ECT, n = 24). Additionally, a control sample of MDD patients treated solely with pharmacotherapy (MED, n = 23) and a healthy control sample (HC, n = 22) were obtained.

RESULTS:

Before therapy, both patient groups equally showed elevated amygdala reactivity to sad faces compared with HC. After treatment, a decrease in amygdala activity to negative stimuli was discerned in both patient samples indicating a normalization of amygdala function, suggesting mechanisms potentially unspecific for ECT. Moreover, a decrease in amygdala activity to sad faces was associated with symptomatic improvements in the ECT sample (r spearman = -0.48, p = 0.044), and by tendency also for the MED sample (r spearman = -0.38, p = 0.098). However, we did not find any significant association between pre-treatment amygdala function to emotional stimuli and individual symptom improvement, neither for the ECT sample, nor for the MED sample.

CONCLUSIONS:

In sum, the present study provides first results regarding functional changes in emotion processing due to ECT treatment using a longitudinal design, thus validating and extending our knowledge gained from previous treatment studies. A limitation was that ECT patients received concurrent medication treatment.

KEYWORDS:

Amygdala; depression; electroconvulsive therapy; emotion processing; functional magnetic resonance imaging

PMID:
28397635
DOI:
10.1017/S0033291717000605
[Indexed for MEDLINE]

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