Archival ReportAbnormal Cingulate and Prefrontal Cortical Neurochemistry in Major Depression After Electroconvulsive Therapy
Section snippets
Participants
A total of 27 patients fulfilling the diagnostic criteria for MDD (DSM-IV) and referred to ECT due to clinical indication and 27 healthy sex-matched control subjects were enrolled from January 2005 to December 2008. Diagnoses were established by two independent experienced psychiatrists based on a clinical interview following DSM-IV criteria. Patients with a medical history of alcohol und drug abuse, schizophrenia, or dementia were excluded. Medication resistance was measured with the
Results
Gender, age, length of index episode, lifetime number of depressive episodes, Beck Depression Inventory, and Montgomery Åsberg Rating Scale sores at T0, at T_acute, and at T1 are summarized in Table 1. Clinical outcome was calculated at T_acute and showed an initial early response rate of 32% (response criteria of 50% HDRS score reduction); after continuation, 68% of the patients responded to RUL ECT (Table 1). Nonresponse and withdrawal of ECT were defined by a senior psychiatrist considering
Discussion
The main findings of the present study are 1) reduced glutamate and NAA levels in the anterior cingulum in patients with depression compared with healthy subjects, 2) that a high glutamate at T0 predicted a greater improvement after ECT, and 3) decreased NAA levels in the DLPFC and increased NAA levels in the anterior cingulum in responders to ECT. Additionally, in the anterior cingulum, tCr levels were significantly decreased after ECT across all patients.
The observed diminished anterior
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