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Eur Neuropsychopharmacol. 2019 Jul 3. pii: S0924-977X(19)30260-3. doi: 10.1016/j.euroneuro.2019.06.002. [Epub ahead of print]

Transdiagnostic modulation of brain networks by electroconvulsive therapy in schizophrenia and major depression.

Author information

1
Department of Neuroscience (DNS), University of Padova, Padua, Italy. Electronic address: fabio.sambataro@unipd.it.
2
Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, 69115 Heidelberg, Germany; Center for Mental Health, Odenwald District Healthcare Center, Erbach, Germany.
3
Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, 69115 Heidelberg, Germany.
4
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159 Mannheim, Germany.
5
Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, 69115 Heidelberg, Germany; Department of Anaesthesiology, Westpfalz-Klinikum GmbH, 67655 Kaiserslautern, Germany.
6
Department of Anaesthesiology, Westpfalz-Klinikum GmbH, 67655 Kaiserslautern, Germany.
7
Department of Radiology, Section Quantitative Imaging Based Disease Characterization, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
8
Medical Image Computing Group, Division of Medical and Biological Informatics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
9
Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, 69115 Heidelberg, Germany. Electronic address: christian.wolf@med.uni-heidelberg.de.

Abstract

Major depressive disorder (MDD) and schizophrenia (SCZ) share neurobiological and clinical commonalities. Altered functional connectivity of large-scale brain networks has been associated with both disorders. Electroconvulsive therapy (ECT) has proven to be an effective treatment in severe forms of MDD and SCZ. However, the role of ECT on the modulation of the dynamics of brain networks is still unknown. In this study, we used resting state functional magnetic resonance imaging (rs-fMRI) to investigate functional connectivity in 16 pharmacoresistant patients with SCZ or MDD and a matched group of normal controls. Patients were scanned before and after right-sided unilateral ECT. Group spatial independent component analysis was carried out with a multiple analysis of covariance (MANCOVA) approach to estimate the effects of ECT treatment on intrinsic components (INs). Functional network connectivity (FNC) was calculated between pairs of INs. Patients had reduced connectivity within a striato-thalamic network in the thalamus as well as increased low frequency oscillations in a striatal network. ECT reduced low frequency oscillations (LFOs) on a striatal network along with increasing functional connectivity in the medial prefrontal cortex within the DMN. Following ECT treatment, the FNC of the executive network was reduced with the DMN and increased with the salience network, respectively. Our findings suggest transnosological effects of ECT on the connectivity of large-scale networks as well as at the level of their interplay. Furthermore, they support a transnosological approach for the investigation not only of the neural correlates of the disease but also of the brain mechanism of treatment of mental disorders.

KEYWORDS:

Default mode network; Functional connectivity; Functional magnetic resonance imaging; Medial prefrontal cortex; Salience network

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