Neurobiological mechanisms of ECT and TMS treatment in depression: study protocol of a multimodal magnetic resonance investigation.

Autor: Frid LM; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway., Kessler U; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway., Ousdal OT; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway.; Department of Biomedicine, University of Bergen, Bergen, Norway., Hammar Å; Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.; Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden.; Office for Psychiatry and Habilitation, , Psychiatry Research Skåne, Region Skåne, Sweden., Haavik J; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.; Department of Biomedicine, University of Bergen, Bergen, Norway., Riemer F; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway., Hirnstein M; Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway., Ersland L; Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway., Erchinger VJ; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway., Ronold EH; Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.; Department of Neurology, Haukeland University Hospital, Bergen, Norway., Nygaard G; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway., Jakobsen P; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; NORMENT, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway., Craven AR; Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.; Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway., Osnes B; Department of Clinical Psychology, University of Bergen, Bergen, Norway., Alisauskiene R; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway., Bartsch H; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway., Le Hellard S; NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway.; Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway., Stavrum AK; NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway.; Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway., Oedegaard KJ; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; NORMENT, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway., Oltedal L; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway. leif.oltedal@uib.no.; Department of Clinical Medicine, University of Bergen, Bergen, Norway. leif.oltedal@uib.no.
Jazyk: angličtina
Zdroj: BMC psychiatry [BMC Psychiatry] 2023 Oct 30; Vol. 23 (1), pp. 791. Date of Electronic Publication: 2023 Oct 30.
DOI: 10.1186/s12888-023-05239-0
Abstrakt: Background: Noninvasive neurostimulation treatments are increasingly being used to treat major depression, which is a common cause of disability worldwide. While electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are both effective in treating depressive episodes, their mechanisms of action are, however, not completely understood. ECT is given under general anesthesia, where an electrical pulse is administered through electrodes placed on the patient's head to trigger a seizure. ECT is used for the most severe cases of depression and is usually not prescribed before other options have failed. With TMS, brain stimulation is achieved through rapidly changing magnetic fields that induce electric currents underneath a ferromagnetic coil. Its efficacy in depressive episodes has been well documented. This project aims to identify the neurobiological underpinnings of both the effects and side effects of the neurostimulation techniques ECT and TMS.
Methods: The study will utilize a pre-post case control longitudinal design. The sample will consist of 150 subjects: 100 patients (bipolar and major depressive disorder) who are treated with either ECT (N = 50) or TMS (N = 50) and matched healthy controls (N = 50) not receiving any treatment. All participants will undergo multimodal magnetic resonance imaging (MRI) as well as neuropsychological and clinical assessments at multiple time points before, during and after treatment. Arterial spin labeling MRI at baseline will be used to test whether brain perfusion can predict outcomes. Signs of brain disruption, potentiation and rewiring will be explored with resting-state functional MRI, magnetic resonance spectroscopy and multishell diffusion weighted imaging (DWI). Clinical outcome will be measured by clinician assessed and patient reported outcome measures. Memory-related side effects will be investigated, and specific tests of spatial navigation to test hippocampal function will be administered both before and after treatment. Blood samples will be stored in a biobank for future analyses. The observation time is 6 months. Data will be explored in light of the recently proposed disrupt, potentiate and rewire (DPR) hypothesis.
Discussion: The study will contribute data and novel analyses important for our understanding of neurostimulation as well as for the development of enhanced and more personalized treatment.
Trial Registration: ClinicalTrials.gov Identifier: NCT05135897.
(© 2023. The Author(s).)
Databáze: MEDLINE
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