Disruptions of Brain Networks and Sleep by Electroconvulsive Therapy

电休克疗法对大脑网络和睡眠的干扰

• 批准号: 10669272
• 负责人: MohammadMehdi Kafashan
• 金额: $ 15.85万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10669272
• 关键词: Accounting; Adult; Age; Antidepressive Agents; Arousal; Biological Markers; Bipolar Depression; Brain; Clinic; Clinical; Cognition; Cognitive; Development; Dryness; Electroconvulsive Therapy; Electrodes; Electroencephalography; Episodic memory; Eye; Frequencies; General Anesthesia; Generalized seizures; Goals; Graph; Homeostasis; Impaired cognition; Individual; Intervention; Investigation; Length; Longitudinal Studies; Major Depressive Disorder; Measures; Memory; Memory impairment; Mental Depression; Mental disorders; Modeling; Neuronal Plasticity; Outcome; Outpatients; Pathology; Pathway Analysis; Patient-Focused Outcomes; Patients; Performance; Play; Procedures; Property; Psychiatry; Public Health; Regulation; Research; Rest; Role; Seizures; Severities; Short-Term Memory; Signal Transduction; Sleep; Sleep Stages; Sleep disturbances; Slow-Wave Sleep; Sorting; Structure; Synapses; Synaptic plasticity; Technology; United States National Institutes of Health; Wakefulness; Work; antidepressant effect; awake; career; cognitive function; density; depressive symptoms; disability; economic cost; effective intervention; functional plasticity; improved; indexing; information processing; innovation; insight; inventory of depressive symptomatology; neural; neuropsychiatry; non rapid eye movement; pharmacologic; prognostic; psychiatric symptom; recruit; reduce symptoms; response; sex; side effect; sleep abnormalities; stem; therapeutic target; treatment-resistant depression; wearable device; wireless

ABSTRACT Electroconvulsive therapy (ECT) is an effective intervention for treating patients with psychiatric disorders. Specifically, it is an established treatment for patients with Treatment-Resistant Depression (TRD) with a lack of responsiveness to at least two pharmacologic antidepressants. Despite an efficacy of up to 70%, little is known about the circuit-level mechanisms through which ECT alleviates psychiatric symptoms or exerts cognitive impairments. ECT induces generalized seizures and causes neuroplastic changes within functional networks. A better understanding of ECT is urgently needed given that it is a repetitive procedure performed under general anesthesia and its benefits are limited by cognitive impairment following treatment. Electroencephalography (EEG) enables capturing the temporal dynamics of brain activity in different states of arousal and recent developments in high-density EEG technology allow for elucidation of large-scale functional brain networks. Recording EEG during sleep provides insights about sleep structure. In this study, “Disruptions of Brain networks and Sleep by Electroconvulsive Therapy,” we will investigate the impact of ECT on information transfer efficiency in functional networks in relation to sleep slow waves, an EEG marker of synaptic plasticity. The novelty of this proposal stems from our focus on the longitudinal assessment of EEG markers during sleep, wakefulness, and ECT-induced seizures over the course of therapy. We will also acquire depression severity outcomes and memory measures longitudinally. Wireless wearable devices will address previous barriers to the longitudinal study of sleep microstructure in the outpatient ECT settings. Graph-based network analyses of high-density EEG signals allow characterization of information transfer over functional networks. These information measures are investigated locally in specific subnetworks and globally over large-scale functional networks. Longitudinal assessments of EEG throughout the course of ECT alongside clinical and cognitive outcomes will provide a unique opportunity to improve our understanding of the circuit mechanisms underlying the development of cognitive impairments and antidepressant effects incurred during ECT. Furthermore, our findings may shed light on other non-invasive interventions targeting sleep slow wave activity in patients with psychiatric illnesses. Overall, elucidating the impact of ECT on information processing in different states of arousal may have promising clinical implications through identification of potential new biomarkers and therapeutic targets leading to the improvement of public health for TRD patients.

抽象的 电休克疗法（ECT）是治疗精神疾病患者的有效干预措施。 具体来说，它是针对缺乏治疗的难治性抑郁症 (TRD) 患者的既定治疗方法。 尽管疗效高达 70%，但人们对至少两种抗抑郁药的反应知之甚少。 关于 ECT 缓解精神症状或发挥认知能力的回路水平机制 ECT 诱发全身性癫痫发作并导致功能网络内的神经塑性变化。 鉴于 ECT 是在一般情况下进行的重复程序，因此迫切需要更好地了解 ECT 麻醉及其益处受到治疗后认知障碍的限制。 （脑电图）能够捕获不同唤醒状态和最近状态下大脑活动的时间动态 高密度脑电图技术的发展可以阐明大规模的功能性大脑网络。 在睡眠期间记录脑电图可以提供有关睡眠结构的见解。 和电休克疗法睡眠”，我们将研究 ECT 对信息传输效率的影响 与睡眠慢波相关的功能网络，这是突触可塑性的脑电图标记。 该提案源于我们对睡眠、清醒和睡眠期间脑电图标记的纵向评估的关注 在治疗过程中，我们还将获得 ECT 诱发的癫痫发作结果以及抑郁症的严重程度。 无线可穿戴设备将解决纵向记忆测量的障碍。 门诊 ECT 环境中睡眠微结构的研究 基于图的高密度脑电图网络分析。 信号允许表征功能网络上的信息传输这些信息测量是。 在特定子网络中进行本地研究，并在大规模纵向功能网络中进行全球研究。 在 ECT 整个过程中对脑电图的评估以及临床和认知结果将提供 提高我们对发展背后的电路机制的理解的独特机会 此外，我们的研究结果可能会揭示 ECT 期间发生的认知障碍和抗抑郁作用。 针对精神疾病患者睡眠慢波活动的其他非侵入性干预措施。 总体而言，阐明 ECT 对不同唤醒状态下的信息处理的影响可能具有以下作用： 通过识别潜在有前途的新生物标志物和领先的治疗靶点来产生临床意义 改善 TRD 患者的公共卫生。

项目成果

Movements and central positive complexes during an ECT-induced seizure: A video-EEG case.

ECT 诱发癫痫发作期间的运动和中枢阳性复合体：视频脑电图病例。

• DOI: 10.1002/epd2.20144
• 发表时间: 2023
• 期刊: Epileptic disorders : international epilepsy journal with videotape
• 作者: Nayak,ChetanSateesh;Kafashan,MohammadMehdi;Nascimento,FábioA;Farber,NuriB;Palanca,BenJulianA;Hogan,REdward
• 通讯作者: Hogan,REdward