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Rigshospitalet - en del af Københavns Universitetshospital
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Effect of electroconvulsive therapy on neural response to affective pictures: A randomized, sham-controlled fMRI study

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  • K W Miskowiak
  • J Macoveanu
  • M B Jørgensen
  • C V Ott
  • M M Støttrup
  • H M Jensen
  • A Jørgensen
  • C J Harmer
  • O B Paulson
  • H R Siebner
  • L V Kessing
Vis graf over relationer

Electroconvulsive therapy (ECT) is the most effective treatment for severe depression but its neurocognitive mechanisms are unclear. This randomized, sham-controlled functional magnetic resonance imaging (fMRI) study explored the effects of a single ECT on neural response to affective pictures. Twenty-seven patients with major depressive disorder were randomized to a single active ECT (N = 15) or sham (N = 12) session in a double-blind, parallel-group design. On the following day, patients underwent fMRI during which they viewed pleasant, unpleasant and neutral pictures and performed a free recall test after the scan. Mood symptoms were assessed before ECT/sham and at the time of fMRI. Subsequently, all patients continued active ECT as usual. Mood symptoms were reassessed after six active ECT sessions. A single ECT vs. sham session reduced neural response to unpleasant vs. pleasant pictures in the medial prefrontal cortex, a region showing greater response in the more depressed patients. This effect occurred in the absence of between-group differences in picture recall, mood symptoms or concomitant medication. In conclusion, modulation of medial prefrontal hyper-activity during encoding of negative affective information may be a common mechanism of distinct biological depression treatments.

OriginalsprogEngelsk
TidsskriftEuropean neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
Vol/bind28
Udgave nummer8
Sider (fra-til)915-924
Antal sider10
ISSN0924-977X
DOI
StatusUdgivet - aug. 2018

ID: 54683858