Abstract：
Electroconvulsive therapy (ECT) demonstrates favorable outcomes in the management of severe depressive disorders. ECT has been consistently associated with volumetric increases in the amygdala and hippocampus. However, the underlying mechanisms of these structural changes and their association to clinical improvement remains unclear. In this cross-sectional structural MRI study, we assessed the difference in amygdala subnuclei and hippocampus subfields in n = 37 patients with either unipolar or bipolar disorder immediately after eighth ECT sessions compared to (n = 40) demographically matched patients in partial remission who did not receive ECT (NoECT group). Relative to NoECT, the ECT group showed significantly larger bilateral amygdala volumes post-treatment, with the effect originating from the lateral, basal, and paralaminar nuclei and the left corticoamydaloid transition area. No significant group differences were observed for the hippocampal or cortical volumes. ECT was associated with a significant decrease in depressive symptoms. However, there were no significant correlations between amygdala subnuclei volumes and symptom improvement. Our study corroborates previous reports on increased amygdalae volumes following ECT and further identifies the subnuclei driving this effect. However, the therapeutic effect of ECT does not seem to be directly related to structural changes in the amygdala.
摘要：
电惊厥治疗（ECT）在严重抑郁症的治疗中显示出良好的结果。ECT一直与杏仁核和海马体的体积增加有关。然而,这些结构变化的潜在机制及其与临床改善的关联尚不清楚.在这项横断面结构MRI研究中，我们评估了n=37例单相或双相障碍患者在第8次ECT治疗后立即出现杏仁核亚核和海马亚区的差异,与(n=40)未接受ECT治疗的部分缓解患者(NoECT组)相比.相对于NoECT,ECT组治疗后双侧杏仁核体积明显增大,效果来自横向，基底,和层旁核和左侧皮质淀粉样过渡区。海马或皮质体积未观察到显着的组差异。ECT与抑郁症状的显着减少有关。然而,杏仁核亚核体积与症状改善之间没有显着相关性。我们的研究证实了先前关于ECT后杏仁核体积增加的报道，并进一步确定了驱动这种作用的亚核。然而,ECT的治疗效果似乎与杏仁核的结构变化没有直接关系。
