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ECT-Induced Effects on Hippocampal Structure and Function and Its Differences in Schizophrenia Remission and Non-Remission Patients

40 Pages Posted: 2 Mar 2019

See all articles by Yuchao Jiang

Yuchao Jiang

University of Electronic Science and Technology of China (UESTC) - The Clinical Hospital of Chengdu Brain Science Institute

Lihau Xu

Shanghai Jiao Tong University (SJTU) - Shanghai Key Laboratory of Psychotic Disorders

Xiangkui Li

University of Electronic Science and Technology of China (UESTC) - The Clinical Hospital of Chengdu Brain Science Institute

Yingying Tang

Shanghai Jiao Tong University (SJTU) - School of Medicine; Shanghai Jiao Tong University (SJTU)

Chunbo Li

Shanghai Jiao Tong University (SJTU) - Shanghai Key Laboratory of Psychotic Disorders; Shanghai Jiao Tong University (SJTU)

Jijun Wang

Shanghai Jiao Tong University (SJTU) - Shanghai Key Laboratory of Psychotic Disorders

Cheng Luo

University of Electronic Science and Technology of China (UESTC) - The Clinical Hospital of Chengdu Brain Science Institute

Dezhong Yao

University of Electronic Science and Technology of China (UESTC) - The Clinical Hospital of Chengdu Brain Science Institute

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Abstract

Background: Modified electroconvulsive therapy (MECT) is considered as a treatment option in drug-resistant schizophrenia (SZ). But approximately one-third of patients do not benefit from MECT in clinic. Thus it is high significance to investigate differences between MECT responders and non-responders. Accumulated evidence indicated that one of MECT action regions is the hippocampus, which also plays an important role in SZ pathophysiology. To date, no studies have investigated the differences of MECT effects to hippocampus between treatment responders and non-responders.  

Methods: This study recruited twenty-one SZ patients treated by four-weeks MECT (MSZ, n=21) and twenty-one SZ patients who received pharmaceutical therapy (DSZ, n=21). The MSZ was further classified to responders (MSR, n=10) or non-responders (MNR, n=11) according to treatment outcomes by the criterion of 50% PANSS total reductive ratio. Using structural and resting-state functional MRI, we measured the hippocampal volume and functional connectivity (FC) in all SZ patients (before and after treatment) and 23 healthy controls.  

Results: Contrast to pharmaceutical therapy, MECT induced bilateral hippocampal volume increases in MSZ. Both of MSR and MNR exhibited a hippocampus expansion after MECT, whereas a lesser baseline volume at one of hippomcapal subfield (hippocampus-amygdala transition area) was found in MNR. After MECT, increased FC between the hippocampus and brain networks associated with cognitive functions was only observed in MSR.  

Conclusions: MECT action mechanism in schizophrenia is complex. A combination of baseline impairment level, MECT-introduced morphological changes and post-ECT FC increases at the hippocampus may jointly contribute to the post-ECT symptom improvements in SZ.  

Funding Statement: This study was funded by grants from the National Nature Science Foundation of China (grant number: 81861128001, 61761166001, 81471638, 81771822, 81571759, 81660233, 81671332), the Program for Changjiang Scholars and Innovative Research Team Project (IRT0910), the ‘111’ Project (B12027) and grants from Ministry of Science and Technology of China (2016YFC1306800) and SHSMU-ION Research Center for Brain Disorders (2015NKX001).

Declaration of Interests: The authors state: "There is no conflict of interest."

Ethics Approval Statement: The Ethics Committee of SMHC approved the study protocol. Written informed consent was obtained from all subjects prior to study participation.

Keywords: Modified electroconvulsive therapy; schizophrenia; hippocampus; MRI; functional connectivity; resting-state fMRI

Suggested Citation

Jiang, Yuchao and Xu, Lihau and Li, Xiangkui and Tang, Yingying and Li, Chunbo and Wang, Jijun and Luo, Cheng and Yao, Dezhong, ECT-Induced Effects on Hippocampal Structure and Function and Its Differences in Schizophrenia Remission and Non-Remission Patients (February 27, 2019). Available at SSRN: https://ssrn.com/abstract=3343640 or http://dx.doi.org/10.2139/ssrn.3343640

Yuchao Jiang

University of Electronic Science and Technology of China (UESTC) - The Clinical Hospital of Chengdu Brain Science Institute

Chengdu
China

Lihau Xu

Shanghai Jiao Tong University (SJTU) - Shanghai Key Laboratory of Psychotic Disorders

Shanghai
China

Xiangkui Li

University of Electronic Science and Technology of China (UESTC) - The Clinical Hospital of Chengdu Brain Science Institute

Chengdu
China

Yingying Tang

Shanghai Jiao Tong University (SJTU) - School of Medicine

Shanghai
China

Shanghai Jiao Tong University (SJTU)

KoGuan Law School
Shanghai 200030, Shanghai 200052
China

Chunbo Li

Shanghai Jiao Tong University (SJTU) - Shanghai Key Laboratory of Psychotic Disorders ( email )

Shanghai
China

Shanghai Jiao Tong University (SJTU)

KoGuan Law School
Shanghai 200030, Shanghai 200052
China

Jijun Wang

Shanghai Jiao Tong University (SJTU) - Shanghai Key Laboratory of Psychotic Disorders

Shanghai
China

Cheng Luo (Contact Author)

University of Electronic Science and Technology of China (UESTC) - The Clinical Hospital of Chengdu Brain Science Institute ( email )

Chengdu
China

Dezhong Yao

University of Electronic Science and Technology of China (UESTC) - The Clinical Hospital of Chengdu Brain Science Institute

Chengdu
China

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