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.

电抽搐疗法（ECT）是一种针对重度抑郁症（MDD）的快速有效的治疗方法，通常伴有认知障碍。最近的研究表明ECT可以重组失调的内部/内部连接的大脑网络，包括情感网络，认知控制网络（CCN）和默认模式网络（DMN）。认知加工。然而，关于ECT后的脑-小脑连接改变与抗抑郁作用或认知障碍之间的关系知之甚少。我们对28名接受ECT的MDD患者和20名健康对照者进行了基于种子的静止状态功能连通性（RSFC）分析，以确定与MDD和ECT引起的变化相关的脑小脑连通性差异。选择了大脑中的六个种子区域（每半球三个）用于RSFC，对应于情感网络CCN和DMN，以建立与小脑的脑小脑功能连接。MDD患者在ECT后显示左sgACC和左小脑小叶VI之间的RSFC增加。Ggranger因果关系分析（GCA）确定了因果关系是从左小脑小叶VI到左sgACC。此外，从左小脑小叶VI到左sgACC的有效连接性增强与ECT后口语流利测试（VFT）得分的变化呈正相关（选择了大脑中的六个种子区域（每半球三个）用于RSFC，对应于情感网络CCN和DMN，以建立与小脑的脑小脑功能连接。MDD患者在ECT后显示左sgACC和左小脑小叶VI之间的RSFC增加。Ggranger因果关系分析（GCA）确定了因果关系是从左小脑小叶VI到左sgACC。此外，从左小脑小叶VI到左sgACC的有效连接性增强与ECT后口语流利测试（VFT）得分的变化呈正相关（选择了大脑中的六个种子区域（每半球三个）用于RSFC，对应于情感网络CCN和DMN，以建立与小脑的脑小脑功能连接。MDD患者显示ECT后左sgACC和左小脑小叶VI之间的RSFC增加。Ggranger因果关系分析（GCA）确定了因果关系是从左小脑小叶VI到左sgACC。此外，从左小脑小叶VI到左sgACC的有效连接性增强与ECT后口语流利测试（VFT）得分的变化呈正相关（MDD患者在ECT后显示左sgACC和左小脑小叶VI之间的RSFC增加。Ggranger因果关系分析（GCA）确定了因果关系是从左小脑小叶VI到左sgACC。此外，从左小脑小叶VI到左sgACC的有效连接性增强与ECT后口语流利测试（VFT）得分的变化呈正相关（MDD患者在ECT后显示左sgACC和左小脑小叶VI之间的RSFC增加。Ggranger因果关系分析（GCA）确定了因果关系是从左小脑小叶VI到左sgACC。此外，从左小脑小叶VI到左sgACC的有效连接性增强与ECT后口语流利测试（VFT）得分的变化呈正相关（r  = 0.433，p  = 0.039）。我们的发现表明，从左小叶VI到左sgACC增强的脑小脑功能连接性可能会改善ECT所致的认知障碍。这项研究确定了缓解ECT后认知障碍的潜在神经途径。