Clinical effects of electroconvulsive therapy in severe depression and concomitant changes in cerebral glucose metabolism--an exploratory study.

Abstract:

OBJECTIVE:Electroconvulsive therapy (ECT) is an effective mode of treatment--especially for severe depression and for depression refractory to pharmacotherapy, nevertheless the mode of action of ECT is far from being fully understood. This study assessed the effects of a series of ECT in depressive subjects on cerebral glucose metabolism measured by FDG-PET scans pre- and post-therapy in thus far the largest group of 12 patients. METHODS:Our analysis included careful repeated evaluation of clinical changes in mood and behaviour by standardised questionnaires, which allowed testing for a potential correlation between clinical and cerebral metabolic changes. PET scanning was done within a predefined time window and we used predefined ROIs with counts normalized to the pons activity. RESULTS:We observed few changes in cerebral glucose metabolism over time. There was a marginal increase in the left temporal and a trend for a decrease in left frontobasal areas subsequent to treatment in our sample. FDG uptake patterns remained remarkably stable in all the other predefined ROIs pre- and post-treatment. There were no significant correlations between changes in relative metabolic rates and changes in depression scores and parameters derived from neurocognitive testing. CONCLUSIONS:Our study thus cannot support the view that FDG-PET can assess the functional brain changes that are likely to occur subsequent to ECT in such a scenario, but this may be related to limited sensitivity given the sample size. Future studies thus might wish to challenge this notion in larger patient samples to clarify this issue.

journal_name

J Affect Disord

authors

Reininghaus EZ,Reininghaus B,Ille R,Fitz W,Lassnig RM,Ebner C,Annamaria P,Hofmann P,Kapfhammer HP,Reingard A,Fazekas F,Ropele S,Enzinger C

doi

10.1016/j.jad.2012.07.034

subject

Has Abstract

pub_date

2013-04-05 00:00:00

pages

290-4

issue

2

eissn

0165-0327

issn

1573-2517

pii

S0165-0327(12)00565-4

journal_volume

146

pub_type

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