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 电击疗法（ECT）是治疗精神疾病患者的有效干预措施。 具体而言，这是针对耐药抑郁症患者（TRD）的既定治疗方法 对至少两种药理抗抑郁药的反应。尽管效率高达70％，但知之甚少 关于电路级机制减轻精神症状或出口认知的机制 障碍。 ECT诱导广义性癫痫发作，并在功能网络中引起神经塑性变化。一个 迫切需要更好地理解ECT，这是一般下执行的重复程序 麻醉及其益处受到治疗后认知障碍的限制。脑电图 （脑电图）能够捕获不同唤醒和最新状态中大脑活动的暂时动态 高密度脑电图技术的发展允许阐明大型功能性脑网络。 在睡眠期间记录脑电图提供有关睡眠结构的见解。在这项研究中，“大脑网络的破坏 并通过电击疗法睡眠，”我们将研究ECT对信息传递效率的影响 在功能网络中，与睡眠慢波有关，这是突触可塑性的脑电图标记。这个新奇 提议从我们对睡眠，清醒和 在治疗过程中，ECT诱导的癫痫发作。我们还将获得抑郁症的严重性结果和 记忆纵向测量。无线可穿戴设备将解决以前的纵向障碍 研究门诊环境中的睡眠微观结构。基于图的高密度脑电图网络分析 信号允许在功能网络上表征信息传输。这些信息度量是 在特定的子网和全球范围内通过大规模功能网络进行了研究。纵向 在整个ECT过程中对脑电图的评估以及临床和认知结果以及 独特的机会来提高我们对发展的电路机制的理解 ECT期间产生的认知障碍和抗抑郁作用。此外，我们的发现可能会熄灭 针对精神病患者的其他非侵入性干预措施，针对睡眠慢波活动。 总体而言，阐明ECT对不同唤醒状态中信息处理的影响可能 通过确定潜在的新生物标志物和治疗靶标的临床意义 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