Altered functional connectivity patterns of insular subregions in major depressive disorder after electroconvulsive therapy
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Although electroconvulsive therapy (ECT) is an efficient treatment for major depressive disorder (MDD), however, it also brings memory impairment. The insula is a critical brain structure for coordinating affective, cognitive memory, saliency processing, and attention switching suggesting functional activity of insula maybe an important indicator to delineate the treatment and side effects of ECT. Here, Resting-state functional connectivity analyses of insular subregions were performed to reveal the changes of connectivity in 23 MDD patients before and after ECT and 25 healthy control (HC) and identified significantly increased functional connectivity of the right ventral anterior insular subregion with bilateral caudate, angular gyrus, and dorsolateral prefrontal cortex after ECT. Granger causality analyses identified significantly increased effective connectivity from dorsolateral prefrontal cortex to right angular gyrus in MDD patients after ECT. Furthermore, increased effective connectivity from dorsolateral prefrontal cortex to right angular gyrus exhibited significantly positive correlation with changed Hamilton Rating Scale for Depression scores. These results showed that ECT can normalize abnormal functional connectivity and effective connectivity in MDD. Our findings also indicated that the right ventral anterior insula and effective connectivity from dorsolateral prefrontal cortex to right angular gyrus are biomarkers of antidepressant effects during ECT of MDD.
KeywordsECT MDD Insular subregions Resting-state Granger causality analyses
This work was supported by the Natural Science Foundation of China (31500867, 81601187, 81671354, and 81471117), the National Basic Research Program of China (973 program, 2015CB856400).
- Bouckaert, F., De Winter, F. L., Emsell, L., Dols, A., Rhebergen, D., Wampers, M., Sunaert, S., Stek, M., Sienaert, P., & Vandenbulcke, M. (2016). Grey matter volume increase following electroconvulsive therapy in patients with late life depression: A longitudinal MRI study. Journal of Psychiatry & Neuroscience, 41, 105–114.CrossRefGoogle Scholar
- Ellard, K.K., Zimmerman, J.P., Kaur, N., Dijk, K.R.A.V., Roffman, J.L., Nierenberg, A.A., Dougherty, D.D., Deckersbach, T., Camprodon, J.A., 2018. Functional connectivity between anterior insula and key nodes of frontoparietal executive control and salience networks distinguish bipolar depression from unipolar depression and healthy controls. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging In Press.Google Scholar
- Goulden, N., Khusnulina, A., Davis, N. J., Bracewell, R. M., Bokde, A. L., McNulty, J. P., & Mullins, P. G. (2014). The salience network is responsible for switching between the default mode network and the central executive network: Replication from DCM. Neuroimage, 99, 180–190.CrossRefGoogle Scholar
- Lanzenberger, R., Baldinger, P., Hahn, A., Ungersboeck, J., Mitterhauser, M., Winkler, D., Micskei, Z., Stein, P., Karanikas, G., Wadsak, W., Kasper, S., & Frey, R. (2013). Global decrease of serotonin-1A receptor binding after electroconvulsive therapy in major depression measured by PET. Molecular Psychiatry, 18, 93–100.CrossRefGoogle Scholar
- Liu, Z., Xu, C., Xu, Y., Wang, Y., Zhao, B., Lv, Y., Cao, X., Zhang, K., & Du, C. (2010). Decreased regional homogeneity in insula and cerebellum: A resting-state fMRI study in patients with major depression and subjects at high risk for major depression. Psychiatry Research, 182, 211–215.CrossRefGoogle Scholar
- Oltedal, L., Kessler, U., Ersland, L., Gruner, R., Andreassen, O. A., Haavik, J., Hoff, P. I., Hammar, A., Dale, A. M., Hugdahl, K., & Oedegaard, K. J. (2015). Effects of ECT in treatment of depression: Study protocol for a prospective neuroradiological study of acute and longitudinal effects on brain structure and function. BMC Psychiatry, 15, 94.CrossRefGoogle Scholar
- Pizzagalli, D. A., Holmes, A. J., Dillon, D. G., Goetz, E. L., Birk, J. L., Bogdan, R., Dougherty, D. D., Iosifescu, D. V., Rauch, S. L., & Fava, M. (2009). Reduced caudate and nucleus accumbens response to rewards in unmedicated individuals with major depressive disorder. The American Journal of Psychiatry, 166, 702–710.CrossRefGoogle Scholar
- Sun, H., Luo, L., Yuan, X., Zhang, L., He, Y., Yao, S., Wang, J., & Xiao, J. (2018). Regional homogeneity and functional connectivity patterns in major depressive disorder, cognitive vulnerability to depression and healthy subjects. Journal of Affective Disorders, 235, 229–235.CrossRefGoogle Scholar
- Wang, J., Wei, Q., Bai, T., Zhou, X., Sun, H., Becker, B., Tian, Y., Wang, K., & Kendrick, K. (2017b). Electroconvulsive therapy selectively enhanced feedforward connectivity from fusiform face area to amygdala in major depressive disorder. Social Cognitive and Affective Neuroscience, 12, 1983–1992.CrossRefGoogle Scholar
- Wu, H., Sun, H., Xu, J., Wu, Y., Wang, C., Xiao, J., She, S., Huang, J., Zou, W., Peng, H., Lu, X., Huang, G., Jiang, T., Ning, Y., & Wang, J. (2016). Changed hub and corresponding functional connectivity of Subgenual anterior cingulate cortex in major depressive disorder. Frontiers in Neuroanatomy, 10, 120.PubMedPubMedCentralGoogle Scholar