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PNAS:电惊厥疗法或可治疗抑郁症

作者:MedSci 来源:MedSci 日期:2022-01-12
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         电惊厥疗法可能因通过改变大脑连接进而治疗抑郁症。

关键字:  抑郁症 |  | 电惊厥 |  

        国际著名杂志PNAS在线刊登了国外研究人员的最新研究成果“Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder,”,文章中,研究者表示,电惊厥疗法可能因通过改变大脑连接进而治疗抑郁症

        一项研究报告说,电惊厥疗法(ECT)目前是治疗严重抑郁症的最有效的疗法,它可能因通过改变大脑的功能架构而起作用。尽管电惊厥疗法(ECT)在临床上已经取得了70多年的成功,它起作用的机制仍然不明确。Jennifer S. Perrin及其同事使用功能磁共振成像(fMRI)研究了电惊厥疗法(ECT)对9位病人的大脑功能连接的影响,这9位病人成功地接受了对严重抑郁症的治疗。

        电惊厥疗法看上去下调了左前额叶背外侧区域的平均全脑连接,此前人们认为这个脑部区域参与了抑郁症而且已知能够影响认知功能。进一步的分析显示电惊厥疗法(ECT)减少了与这个区域有关的大脑功能网络的连接,同时病人的抑郁症状得到了显著改善。这组作者提出,这些发现提示增强了的连接可能是抑郁症重要方面的基础。这组作者说,对电惊厥疗法(ECT)机制的理解可以让科研人员在造成更小的创伤的情况下重复它的治疗效果。

        doi:10.1073/pnas.1117206109

        Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder

        Jennifer S. Perrina,1, Susanne Merzb, Daniel M. Bennetta, James Curriea, Douglas J. Steelec, Ian C. Reida, and Christian Schwarzbauerb

        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.

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