Multi-modal imaging investigation of electroconvulsive therapy response in depre

抑郁症电休克治疗反应的多模态成像研究

• 批准号: 8708155
• 负责人: Christopher C Abbott
• 金额: $ 27.51万
• 依托单位: THE MIND RESEARCH NETWORK
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8708155
• 关键词: Academic Medical Centers; Affect; Anticonvulsants; Biological Markers; Brain; Centers of Research Excellence; Clinical; Cognition; Data; Depressed mood; Depressive disorder; Development; Diagnostic; Disease; Electroconvulsive Therapy; Frequencies; Functional Magnetic Resonance Imaging; Functional disorder; Gold; Image; Investigation; Link; Measures; Mental Depression; Methods; Modality; Multimodal Imaging; Neurobiology; Neurotransmitters; Patients; Pharmacological Treatment; Physiologic pulse; Placebos; Property; Protocols documentation; Protons; Psychiatry; Recording of previous events; Relative (related person); Research; Resistance; Rest; Seizures; Series; Spectrum Analysis; Stimulus; Symptoms; Therapeutic; Therapeutic Intervention; Urban Hospitals; Width; case control; cingulate gyrus; depressive symptoms; effective therapy; functional disability; gamma-Aminobutyric Acid; grasp; improved; independent component analysis; longitudinal design; neuropsychiatry; neuropsychological; neuroregulation; relating to nervous system; response; standard care; success; suicidal; treatment-resistant depression; Academic Medical Centers; Affect; Anticonvulsants; Biological Markers; Brain; Centers of Research Excellence; Clinical; Cognition; Data; Depressed mood; Depressive disorder; Development; Diagnostic; Disease; Electroconvulsive Therapy; Frequencies; Functional Magnetic Resonance Imaging; Functional disorder; Gold; Image; Investigation; Link; Measures; Mental Depression; Methods; Modality; Multimodal Imaging; Neurobiology; Neurotransmitters; Patients; Pharmacological Treatment; Physiologic pulse; Placebos; Property; Protocols documentation; Protons; Psychiatry; Recording of previous events; Relative (related person); Research; Resistance; Rest; Seizures; Series; Spectrum Analysis; Stimulus; Symptoms; Therapeutic; Therapeutic Intervention; Urban Hospitals; Width; case control; cingulate gyrus; depressive symptoms; effective therapy; functional disability; gamma-Aminobutyric Acid; grasp; improved; independent component analysis; longitudinal design; neuropsychiatry; neuropsychological; neuroregulation; relating to nervous system; response; standard care; success; suicidal; treatment-resistant depression

Electroconvulsive therapy (ECT) remains the gold-standard treatment for severe, treatment-resistant patients with depressive episodes. During a typical 4-week ECT series, most depressive episodes remit, and formerly suicidal or psychotically depressed patients will resume their premorbid levels of functioning. ECT is one of psychiatry's most invasive treatments and remains limited to academic medical centers or larger, metropolitan hospitals. Despite ECT's 80-year history, the lack of understanding regarding the neurobiology and the mechanism of action of ECT response limit the development of safer, more accessible treatments. The overall aim of this investigation is to identify the biomarkers of ECT response. A case-control longitudinal design and resting state functional magnetic resonance imaging (fMRI) will simultaneously assess between (Aim 1) and within network changes (Aim 2) associated with ECT response. Our preliminary data supports our hypothesis that ECT response increases between network relationships amid frontal and default mode networks and reduces within network low frequency power (0.01 to 0.1 hertz (Hz)) in the subcallosal cingulate gyrus. The ECT series is associated with increased seizure threshold and reduced seizure duration. These anticonvulsant properties of ECT may be related to the reduction in spectral power within functional networks. In Aim 3, proton spectroscopy (H-MRS) will measure changes in concentrations of gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter, associated with ECT response. The multi-modal aspect of this investigation will link changes in GABA concentrations with changes in the fMRI biomarkers of ECT response (Aims 1 and 2). Specifically, we hypothesize that increased GABA concentrations in the posterior cingulate will correlate with reduced low frequency spectral power (0.01 and 0.1 Hz) within limbic and para-limbic networks. This research will impact the field with a better understanding of the functional neural correlates of ECT response, which will help to optimize ECT treatment parameters (e.g., pulse width, stimulus delivery method, number of treatments) and extend to other therapeutic interventions for treatment-resistant depression.

电击疗法（ECT）仍然是严重，耐药性的金色标准疗法 抑郁发作的患者。在一个典型的4周ECT系列中，大多数抑郁症发作以及 以前自杀或心理抑郁症患者将恢复其起跑前的功能水平。 Ect是 精神病学最具侵入性的治疗之一，仍然限于学术医疗中心或更大的大都市 医院。尽管ECT拥有80年的历史，但对神经生物学和 ECT响应的作用机理限制了更安全，更容易获得的治疗的发展。这 这项研究的总体目的是确定ECT反应的生物标志物。案例对照纵向设计 静止状态功能磁共振成像（fMRI）将同时评估（AIM 1）以及与ECT响应相关的网络变化（目标2）。我们的初步数据支持我们的假设 在额叶和默认模式网络中，网络关系之间的响应增加了 并在网络低频功率（0.01至0.1 Hertz（Hz））内降低。 ECT系列与癫痫发作阈值增加和癫痫发作持续时间的降低有关。这些 ECT的抗惊厥性能可能与功能网络中光谱功率的降低有关。 在AIM 3中，质子光谱法（H-MR）将测量γ-氨基丁酸浓度的变化 （GABA），主要抑制性神经递质，与ECT反应相关。此的多模式方面 研究将将GABA浓度的变化与ECT反应的fMRI生物标志物的变化联系起来 （目标1和2）。具体而言，我们假设后扣带中的GABA浓度升高 与边缘和para-limbic网络内的低频光谱功率（0.01和0.1 Hz）相关。 这项研究将通过更好地理解ECT的功能神经相关性，影响该领域 响应，这将有助于优化ECT治疗参数（例如，脉冲宽度，刺激输送方法， 治疗的数量）并扩展到其他治疗干预措施，以进行抗治疗抑郁症。