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Neural Substrates of Psychotic Depression: Findings From the Global ECT-MRI Research Collaboration
Schizophrenia Bulletin ( IF 6.6 ) Pub Date : 2021-10-08 , DOI: 10.1093/schbul/sbab122
Akihiro Takamiya 1, 2 , Annemiek Dols 3, 4 , Louise Emsell 2 , Christopher Abbott 5 , Antoine Yrondi 6 , Carles Soriano Mas 7, 8, 9 , Martin Balslev Jorgensen 10, 11 , Pia Nordanskog 12 , Didi Rhebergen 13 , Eric van Exel 3, 4 , Mardien L Oudega 3, 4 , Filip Bouckaert 2 , Mathieu Vandenbulcke 2 , Pascal Sienaert 14 , Patrice Péran 15 , Marta Cano 8, 16, 17 , Narcis Cardoner 16 , Anders Jorgensen 10, 11 , Olaf B Paulson 18 , Paul Hamilton 19 , Robin Kampe 19 , Willem Bruin 20 , Hauke Bartsch 21, 22, 23 , Olga Therese Ousdal 21, 24 , Ute Kessler 25, 26 , Guido van Wingen 20 , Leif Oltedal 21, 25 , Taishiro Kishimoto 1
Affiliation  

Abstract
Psychotic major depression (PMD) is hypothesized to be a distinct clinical entity from nonpsychotic major depression (NPMD). However, neurobiological evidence supporting this notion is scarce. The aim of this study is to identify gray matter volume (GMV) differences between PMD and NPMD and their longitudinal change following electroconvulsive therapy (ECT). Structural magnetic resonance imaging (MRI) data from 8 independent sites in the Global ECT-MRI Research Collaboration (GEMRIC) database (n = 108; 56 PMD and 52 NPMD; mean age 71.7 in PMD and 70.2 in NPMD) were analyzed. All participants underwent MRI before and after ECT. First, cross-sectional whole-brain voxel-wise GMV comparisons between PMD and NPMD were conducted at both time points. Second, in a flexible factorial model, a main effect of time and a group-by-time interaction were examined to identify longitudinal effects of ECT on GMV and longitudinal differential effects of ECT between PMD and NPMD, respectively. Compared with NPMD, PMD showed lower GMV in the prefrontal, temporal and parietal cortex before ECT; PMD showed lower GMV in the medial prefrontal cortex (MPFC) after ECT. Although there was a significant main effect of time on GMV in several brain regions in both PMD and NPMD, there was no significant group-by-time interaction. Lower GMV in the MPFC was consistently identified in PMD, suggesting this may be a trait-like neural substrate of PMD. Longitudinal effect of ECT on GMV may not explain superior ECT response in PMD, and further investigation is needed.


中文翻译:

精神病性抑郁症的神经基质:来自全球 ECT-MRI 研究合作的发现

摘要
精神病性重性抑郁症 (PMD) 被假设为与非精神病性重性抑郁症 (NPMD) 不同的临床实体。然而,支持这一观点的神经生物学证据很少。本研究的目的是确定 PMD 和 NPMD 之间的灰质体积 (GMV) 差异及其在电休克疗法 (ECT) 后的纵向变化。来自全球 ECT-MRI 研究协作 (GEMRIC) 数据库中 8 个独立站点的结构磁共振成像 (MRI) 数据 ( n= 108; 56 PMD 和 52 NPMD;分析了 PMD 的平均年龄 71.7 岁和 NPMD 的 70.2 岁)。所有参与者在 ECT 前后均接受了 MRI 检查。首先,在两个时间点进行了 PMD 和 NPMD 之间的横断面全脑体素 GMV 比较。其次,在灵活的因子模型中,检查了时间的主要影响和按时间分组的交互作用,以分别确定 ECT 对 GMV 的纵向影响以及 ECT 在 PMD 和 NPMD 之间的纵向差异效应。与NPMD相比,PMD在ECT前前额叶、颞叶和顶叶皮质的GMV较低;ECT 后 PMD 显示内侧前额叶皮层 (MPFC) 的 GMV 较低​​。尽管时间对 PMD 和 NPMD 的几个大脑区域的 GMV 有显着的主要影响,但没有显着的按时间分组的交互作用。MPFC 中较低的 GMV 在 PMD 中被一致识别,表明这可能是 PMD 的一种类似特征的神经基质。ECT 对 GMV 的纵向影响可能无法解释 ECT 在 PMD 中的优越反应,需要进一步研究。
更新日期:2021-10-08
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