Mechanism of Action of Electroconvulsive Therapy

Massachusetts General Hospital102 enrolled

Overview

This is an observational neuroimaging study assessing the effects of ECT on the brains of patients with unipolar and bipolar depression.

This project aims to use functional connectivity magnetic resonance imaging (fcMRI) to study patients with unipolar and bipolar depression receiving ECT. Patients will be scanned before and after a full course of ECT and clinical measures for depression severity and memory will be obtained at the same times.The project has the following aims and hypothesis: (1) to determine the therapeutic antidepressant mechanism of action of ECT at the circuit level (2) to determine the mechanism of action of iatrogenic amnesia caused by ECT at the circuit level (3) to study the use of fcMRI as a state biomarker for depression (4) to study the use of fcMRI as a predictor of response for depression.

Study Type

OBSERVATIONAL

Enrollment

102

Conditions

Unipolar Depression Bipolar Depression

Interventions

Electroconvulsive TherapyDEVICE

Electrical currents are passed through the brain to intentionally trigger a controlled seizure in order to produce a therapeutic change in neuro-chemistry and circuitry.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Males and Females Between Ages of 18 and 65 * Diagnosis of Major Depressive Disorder without Psychotic Features or Bipolar I/II * Requiring ECT Treatment as Part of Psychiatric Care Exclusion Criteria: * Comorbid diagnoses of Major Depressive Disorder with Psychotic Features, Schizoaffective Disorder, Schizophrenia or Dementia * History of Psychosis * Substance Use Disorder (Abuse or Dependence) with Active Use Within Last 6 Months * Severe or Unstable Medical Illness * Medical Contraindication to Anesthesia or ECT (e.g., Recent Myocardial Infarction)

Locations (1)

Massachusetts General Hospital

Boston, Massachusetts, United States

Outcomes

Primary Outcomes

Changes in Functional Connectivity of Key Nodes

Measured by Magnetic Resonance Imaging, Key Nodes include Subgenual Cingulate, Dorsal Anterior Cingulate, Nucleus Accumbens, Hippocampus, Amygdala and Dorsolateral Prefrontal Cortex

Time frame: Through Treatment Completion, Average of 2 Months

Secondary Outcomes

Changes in Functional Connectivity of Memory Circuits

Measured by Magnetic Resonance Imaging, Memory Circuits Include Hippocampus and Dorsolateral Prefrontal Memory Hubs

Time frame: Through Treatment Completion, Average of 2 Months

Data from ClinicalTrials.gov

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