Journal article
Metabolic Correlates of Antidepressant and Antipsychotic Response in Patients With Psychotic Depression Undergoing Electroconvulsive Therapy
The journal of ECT, Vol.23(4), pp.265-273
2007
DOI: 10.1097/yct.0b013e318150d56d
PMID: 18090701
Abstract
Objectives:
Although electroconvulsive therapy (ECT) is a very effective treatment of depression and psychosis, the mechanisms by which this occurs are not fully delineated. The objective of this study was to investigate the functional alterations in brain metabolism in response to ECT through the use of positron emission tomography assessment of cerebral glucose metabolism before and after a course of ECT.
Methods:
Ten subjects with psychotic depression were studied with positron emission tomography using [18F]fluorodeoxyglucose before and between 2 and 3 weeks after a course of ECT. Statistical parametric mapping and region of interest analyses of the anterior cingulate cortex (ACC) subregions (dorsal, rostral, subcallosal, and subgenual) and hippocampus were used to determine glucose metabolic changes from ECT. The Hamilton Depression Rating Scale and the Scale for Assessing Positive Symptoms were the primary measures used for assessing clinical changes from ECT.
Results:
Electroconvulsive therapy led to significant increases in the left subgenual ACC and hippocampal metabolism, which were directly correlated with each other and to a reduction in depression as measured by total Hamilton Depression Rating Scale scores. Better antidepressant responders had increased, whereas poorer responders had a decreased left subgenual ACC and hippocampal metabolism. The decrease in positive symptoms was also correlated with increased left hippocampal metabolism.
Conclusions:
The antidepressant effect of ECT was correlated with increased metabolism in the left subgenual ACC and hippocampus, whereas the antipsychotic effect of ECT was only correlated with increased left hippocampal metabolism. This finding has implications to better understand the mechanism of antidepressant and antipsychotic effects of ECT.
Details
- Title: Subtitle
- Metabolic Correlates of Antidepressant and Antipsychotic Response in Patients With Psychotic Depression Undergoing Electroconvulsive Therapy
- Creators
- Laurie M Mccormick - University of IowaLaura L BOLES PONTO - University of IowaRon K Pierson - University of IowaHans J Johnson - University of IowaVincent Magnotta - University of IowaMichael C Brumm - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The journal of ECT, Vol.23(4), pp.265-273
- Publisher
- Lippincott Williams and Wilkins
- DOI
- 10.1097/yct.0b013e318150d56d
- PMID
- 18090701
- ISSN
- 1095-0680
- eISSN
- 1533-4112
- Language
- English
- Date published
- 2007
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Psychiatry; Iowa Neuroscience Institute; Pharmaceutical Sciences and Experimental Therapeutics
- Record Identifier
- 9984185370902771
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