Background/Aims/Methods: Electroconvulsive therapy (ECT) is still one of the most potent treatments in the acute phase of major depressive disorder (MDD) and particularly applied in patients considered treatment resistant. However, despite the frequent and widespread use of ECT for #x3e;70 years, the exact neurobiological mechanisms underlying its efficacy remain unclear. The present review aims to describe differential antidepressant and cognitive effects of ECT as well as effects on markers of neural activity and connectivity, neurochemistry, and inflammation that might underlie the treatment response and remission. Results: Region- specific changes in brain function and volume along with changes in concentrations of neurotransmitters and neuroinflammatory cytokines might serve as potential biomarkers for ECT outcomes. Conclusions: However, as current data is not consistent, future longitudinal investigations should combine modalities such as MRI, MR spectroscopy, and peripheral physiological measures to gain a deeper insight into interconnected time- and modality-specific changes in response to ECT.
Neuropsychobiology

中文翻译：

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电休克疗法在治疗重度抑郁症中的差异化作用。

背景/目的/方法：电休克疗法 (ECT) 仍然是重度抑郁症 (MDD) 急性期最有效的治疗方法之一，尤其适用于被认为对治疗有抵抗力的患者。然而，尽管 #x3e;70 年来频繁和广泛地使用 ECT，但其功效背后的确切神经生物学机制仍不清楚。本综述旨在描述 ECT 的不同抗抑郁药和认知作用，以及对可能构成治疗反应和缓解基础的神经活动和连接、神经化学和炎症标志物的影响。结果：脑功能和体积的区域特异性变化以及神经递质和神经炎性细胞因子浓度的变化可能作为 ECT 结果的潜在生物标志物。结论：然而，由于当前数据不一致，未来的纵向研究应结合 MRI、MR 波谱和外周生理测量等方式，以更深入地了解 ECT 响应的相互关联的时间和方式特定变化。
神经心理生物学