Abstract
Electroconvulsive therapy (ECT), a rapidly acting and effective treatment for major depressive disorder (MDD), is frequently accompanied by cognitive impairment. Recent studies have documented that ECT reorganizes dysregulated inter/intra- connected cerebral networks, including the affective network, the cognitive control network(CCN) and default mode network (DMN).Moreover, cerebellum is thought to play an important role in emotion regulation and cognitive processing. However, little is known about the relationship between cerebro-cerebellar connectivity alterations following ECT and antidepressant effects or cognitive impairment. We performed seed-based resting-state functional connectivity (RSFC) analyses in 28 MDD patients receiving ECT and 20 healthy controls to identify cerebro-cerebellar connectivity differences related to MDD and changes induced by ECT. Six seed regions (three per hemisphere) in the cerebrum were selected for RSFC, corresponding to the affective network, CCN and DMN, to establish cerebro-cerebellar functional connectivity with cerebellum. MDD patients showed increased RSFC between left sgACC and left cerebellar lobule VI after ECT. Ggranger causality analyses (GCA) identified the causal interaction is from left cerebellar lobule VI to left sgACC. Furthermore, increased effective connectivity from left cerebellar lobule VI to left sgACC exhibited positively correlated with the change in verbal fluency test (VFT) score following ECT (r = 0.433, p = 0.039). Our findings indicate that the enhanced cerebro-cerebellar functional connectivity from left lobule VI to left sgACC may ameliorate cognitive impairment induced by ECT. This study identifies a potential neural pathway for mitigation of cognitive impairment following ECT.
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Thanks to all medical workers for their contributions and all participants for their participation in this study.
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This study was funded by the National Natural Science Foundation of China (81601187 and 81671354) and Science fund for outstanding youth of Anhui Province (1808085J23).
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Author contributions included study design and protocol writing(YT and WK), literature search and analysis (TB and QW), data collection (MZ, YG and YM), statistical analysis( GJ ), drafting the manuscript(QW and YJ), approval of final version to be published(All authors).
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Wei, Q., Ji, Y., Bai, T. et al. Enhanced cerebro-cerebellar functional connectivity reverses cognitive impairment following electroconvulsive therapy in major depressive disorder. Brain Imaging and Behavior 15, 798–806 (2021). https://doi.org/10.1007/s11682-020-00290-x
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DOI: https://doi.org/10.1007/s11682-020-00290-x