Bibliographic Details
| Title: |
Electroconvulsive therapy triggers a reversible decrease in brain N-acetylaspartate |
| Authors: |
Vera J. Erchinger, Alexander R. Craven, Lars Ersland, Ketil J. Oedegaard, Christoffer A. Bartz-Johannessen, Åsa Hammar, Jan Haavik, Frank Riemer, Ute Kessler, Leif Oltedal |
| Source: |
Frontiers in Psychiatry, Vol 14 (2023) |
| Publisher Information: |
Frontiers Media S.A., 2023. |
| Publication Year: |
2023 |
| Collection: |
LCC:Psychiatry |
| Subject Terms: |
depression, electroconvulsive therapy, 1H-MRS nuclear magnetic resonance spectroscopy, neurometabolites, choline, myoinositol, Psychiatry, RC435-571 |
| More Details: |
IntroductionBased on previous research on electroconvulsive therapy (ECT) we have proposed a model where disruption, potentiation, and rewiring of brain networks occur in sequence and serve as the underlying therapeutic mechanism of ECT. This model implies that a temporary disturbance of neuronal networks (disruption) is followed by a trophic effect (potentiation), which enables the rewiring of neuronal circuits to a more euthymic functioning brain. We hypothesized that disruption of neuronal networks could trigger biochemical alterations leading to a temporary decrease in N-acetylaspartate (tNAA, considered a marker of neuronal integrity), while choline (a membrane component), myo-Inositol (mI, astroglia marker), and glutamate/glutamine (Glx, excitatory neurotransmitter) were postulated to increase. Previous magnetic resonance spectroscopy studies, reporting diverse findings, have used two different referencing methods - creatine ratios and tissue corrected values referenced to water – for the quantification of brain metabolites. Changes in creatine during ECT have also been reported, which may confound estimates adopting this as an internal reference.MethodsUsing MR spectroscopy, we investigated 31 moderately to severely depressed patients and 19 healthy controls before, during, and after ECT or at similar time points (for controls). We tested whether biochemical alterations in tNAA, choline, mI, and Glx lend support to the disrupt, potentiate, and rewire hypothesis. We used both creatine ratios and water-scaled values for the quantification of brain metabolites to validate the results across referencing methods.ResultsLevels of tNAA in the anterior cingulate cortex decreased after an ECT treatment series (average 10.6 sessions) by 6% (p = 0.007, creatine ratio) and 3% (p = 0.02, water referenced) but returned to baseline 6 months after ECT. Compared to after treatment series tNAA levels at 6-month follow-up had increased in both creatine ratio (+6%, p |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1664-0640 |
| Relation: |
https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1155689/full; https://doaj.org/toc/1664-0640 |
| DOI: |
10.3389/fpsyt.2023.1155689 |
| Access URL: |
https://doaj.org/article/eb3616d0646044b8b890459b5b26bc8e |
| Accession Number: |
edsdoj.b3616d0646044b8b890459b5b26bc8e |
| Database: |
Directory of Open Access Journals |
