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Effects of electroconvulsive therapy on amygdala function in major depression – a longitudinal functional magnetic resonance imaging study

Published online by Cambridge University Press:  11 April 2017

R. Redlich ,
C. Bürger ,
K. Dohm ,
D. Grotegerd ,
N. Opel ,
D. Zaremba ,
S. Meinert ,
K. Förster ,
J. Repple  and
R. Schnelle
...Show all authors
R. Redlich*
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
C. Bürger
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
K. Dohm
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
D. Grotegerd
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
N. Opel
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
D. Zaremba
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
S. Meinert
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
K. Förster
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
J. Repple
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
R. Schnelle
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
C. Wagenknecht
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
M. Zavorotnyy
Affiliation:
Department of Psychiatry, University of Marburg, Marburg, Germany
W. Heindel
Affiliation:
Department of Clinical Radiology, University of Münster, Münster, Germany
H. Kugel
Affiliation:
Department of Clinical Radiology, University of Münster, Münster, Germany
M. Gerbaulet
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
J. Alferink
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany Cells-in-Motion Cluster of Excellence, University of Münster, Münster, Germany
V. Arolt
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
P. Zwanzger
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany Inn-Salzach Hospital, Wasserburg am Inn, Germany Ludwig-Maximilians-University Munich, Munich, Germany
U. Dannlowski
Affiliation:
Department of Psychiatry, University of Münster, Münster, Germany
*
*Address for correspondence: R. Redlich, Ph.D., Department of Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, A9, 48149 Münster, Germany. (Email: [email protected])
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Abstract

Background

Electroconvulsive therapy (ECT) is one of the most effective treatments for severe depression. However, little is known regarding brain functional processes mediating ECT effects.

Method

In a non-randomized prospective study, functional magnetic resonance imaging data during the automatic processing of subliminally presented emotional faces were obtained twice, about 6 weeks apart, in patients with major depressive disorder (MDD) before and after treatment with ECT (ECT, n = 24). Additionally, a control sample of MDD patients treated solely with pharmacotherapy (MED, n = 23) and a healthy control sample (HC, n = 22) were obtained.

Results

Before therapy, both patient groups equally showed elevated amygdala reactivity to sad faces compared with HC. After treatment, a decrease in amygdala activity to negative stimuli was discerned in both patient samples indicating a normalization of amygdala function, suggesting mechanisms potentially unspecific for ECT. Moreover, a decrease in amygdala activity to sad faces was associated with symptomatic improvements in the ECT sample (rspearman = −0.48, p = 0.044), and by tendency also for the MED sample (rspearman = −0.38, p = 0.098). However, we did not find any significant association between pre-treatment amygdala function to emotional stimuli and individual symptom improvement, neither for the ECT sample, nor for the MED sample.

Conclusions

In sum, the present study provides first results regarding functional changes in emotion processing due to ECT treatment using a longitudinal design, thus validating and extending our knowledge gained from previous treatment studies. A limitation was that ECT patients received concurrent medication treatment.

Keywords

Amygdaladepressionelectroconvulsive therapyemotion processingfunctional magnetic resonance imaging
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 12 , September 2017 , pp. 2166 - 2176
Copyright
Copyright © Cambridge University Press 2017 

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