Electroconvulsive therapy effects on anhedonia and reward circuitry anatomy: A dimensional structural neuroimaging approach
Por:
Cano, M, Lee, E, Worthley, A, Ellard, K, Barbour, T, Soriano-Mas, C, Camprodon, JA
Publicada:
15 sep 2022
Ahead of Print:
1 jul 2022
Resumen:
Background: Anhedonia is a core symptom of major depressive disorder (MDD) resulting from maladaptive reward processing. Electroconvulsive therapy (ECT) is an effective treatment for patients with MDD. No previous neuroimaging studies have taken a dimensional approach to assess whether ECT-induced volume changes are specifically related to improvements in anhedonia and positive valence emotional constructs. We aimed to assess the relationship between ECT-induced brain volumetric changes and improvement in anhedonia and reward processing in patients with MDD. Methods: We evaluated 15 patients with MDD before and after ECT. We used magnetic resonance imaging, clinical scales (i.e., Quick Inventory of Depressive Symptomatology for syndromal depression severity and Snaith-Hamilton Pleasure Scale for anhedonia) and the Temporal Experience of Pleasure Scale for anticipatory and consummatory experiences of pleasure. We identified 5 regions of interest within the reward circuit and a 6th control region relevant for MDD but not core to the reward system (Brodmann Area 25). Results: Anhedonia, anticipatory and consummatory reward processing improved after ECT. Volume increases within the right reward system separated anhedonia responders and non-responders. Improvement in antici-patory (but not consummatory) reward correlated with increases in volume in hippocampus, amygdala, ventral tegmental area and nucleus accumbens. Limitations: We evaluated a modest sample size of patients with concurrent pharmacological treatment using a subjective psychometric assessment. Conclusions: We highlight the importance of a dimensional and circuit-based approach to understanding target engagement and the mechanism of action of ECT, with the goal to define symptom-and circuit-specific response biomarkers for device neuromodulation therapies.
Filiaciones:
Cano, M:
Harvard Med Sch, Massachusetts Gen Hosp, Dept Psychiat, Boston, MA 02115 USA
Parc Tauli Univ Hosp, Unitat Neuroci Ncia Traslac, Mental Hlth Dept, Inst Invest & Innovacio Sanitaria Parc Tauli I3P, Barcelona, Spain
Carlos III Hlth Inst, CIBERSAM, Madrid, Spain
Univ Autonoma Barcelona, Dept Psychobiol & Methodol Hlth Sci, Barcelona, Spain
Lee, E:
Harvard Med Sch, Massachusetts Gen Hosp, Dept Psychiat, Boston, MA 02115 USA
Worthley, A:
Harvard Med Sch, Massachusetts Gen Hosp, Dept Psychiat, Boston, MA 02115 USA
Ellard, K:
Harvard Med Sch, Massachusetts Gen Hosp, Dept Psychiat, Boston, MA 02115 USA
Barbour, T:
Harvard Med Sch, Massachusetts Gen Hosp, Dept Psychiat, Boston, MA 02115 USA
Soriano-Mas, C:
Carlos III Hlth Inst, CIBERSAM, Madrid, Spain
Bellvitge Univ Hosp IDIBELL, Dept Psychiat, S-N Feixa Llarga, Barcelona 08907, Spain
Univ Barcelona UB, Dept Social Psychol & Quantitat Psychol, Barcelona, Spain
Camprodon, JA:
Harvard Med Sch, Massachusetts Gen Hosp, Dept Psychiat, Boston, MA 02115 USA
Green Submitted
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