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Altered functional connectivity patterns of insular subregions in major depressive disorder after electroconvulsive therapy

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Abstract

Although electroconvulsive therapy (ECT) is an efficient treatment for major depressive disorder (MDD), however, it also brings memory impairment. The insula is a critical brain structure for coordinating affective, cognitive memory, saliency processing, and attention switching suggesting functional activity of insula maybe an important indicator to delineate the treatment and side effects of ECT. Here, Resting-state functional connectivity analyses of insular subregions were performed to reveal the changes of connectivity in 23 MDD patients before and after ECT and 25 healthy control (HC) and identified significantly increased functional connectivity of the right ventral anterior insular subregion with bilateral caudate, angular gyrus, and dorsolateral prefrontal cortex after ECT. Granger causality analyses identified significantly increased effective connectivity from dorsolateral prefrontal cortex to right angular gyrus in MDD patients after ECT. Furthermore, increased effective connectivity from dorsolateral prefrontal cortex to right angular gyrus exhibited significantly positive correlation with changed Hamilton Rating Scale for Depression scores. These results showed that ECT can normalize abnormal functional connectivity and effective connectivity in MDD. Our findings also indicated that the right ventral anterior insula and effective connectivity from dorsolateral prefrontal cortex to right angular gyrus are biomarkers of antidepressant effects during ECT of MDD.

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Acknowledgements

This work was supported by the Natural Science Foundation of China (31500867, 81601187, 81671354, and 81471117), the National Basic Research Program of China (973 program, 2015CB856400).

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Authors and Affiliations

  1. The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 625014, China

    Lijie Wang & Jiaojian Wang

  2. School of life Science and technology, University of Electronic Science and Technology of China, Chengdu, 625014, China

    Lijie Wang & Jiaojian Wang

  3. Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China

    Qiang Wei, Kai Wang & Yanghua Tian

  4. College of Psychology and Sociology, Shenzhen University, Shenzhen, 518060, China

    Chao Wang

  5. Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China

    Jinping Xu

  6. Department of Medical Psychology, Anhui Medical University, Hefei, 230022, China

    Kai Wang

  7. Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230022, China

    Kai Wang

  8. Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Hefei, 230022, China

    Kai Wang

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  1. Lijie Wang
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Wang, L., Wei, Q., Wang, C. et al. Altered functional connectivity patterns of insular subregions in major depressive disorder after electroconvulsive therapy. Brain Imaging and Behavior 14, 753–761 (2020). https://doi.org/10.1007/s11682-018-0013-z

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