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논문 기본 정보

자료유형
학술저널
저자정보
Moon Sun-Young (Department of Psychiatry Seoul National University College of Medicine) Kim Minah (Department of Psychiatry Seoul National University College of Medicine) Lho Silvia Kyungjin (Department of Psychiatry Seoul National University College of Medicine) Oh Sanghoon (Department of Psychiatry Seoul National University College of Medicine) Kim Se Hyun (Department of Psychiatry Seoul National University College of Medicine) Kwon Jun Soo (독립연구자)
저널정보
대한신경정신의학회 PSYCHIATRY INVESTIGATION PSYCHIATRY INVESTIGATION 제18권 제6호
발행연도
2021.1
수록면
486 - 499 (14page)

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Objective Electroconvulsive therapy (ECT) has been the most potent treatment option for treatment-resistant schizophrenia (TRS). However, the underlying neural mechanisms of ECT in schizophrenia remain largely unclear. This paper examines studies that investigated structural and functional changes after ECT in patients with schizophrenia. Methods We carried out a systematic review with following terms: ‘ECT’, ‘schizophrenia’, and the terms of various neuroimaging modalities. Results Among the 325 records available from the initial search in May 2020, 17 studies were included. Cerebral blood flow in the frontal, temporal, and striatal structures was shown to be modulated (n=3), although the results were divergent. Magnetic resonance spectroscopy (MRS) studies suggested that the ratio of N-acetyl-aspartate/creatinine was increased in the left prefrontal cortex (PFC; n=2) and left thalamus (n=1). The hippocampus and insula (n=6, respectively) were the most common regions of structural/functional modulation, which also showed symptom associations. Functional connectivity of the default mode network (DMN; n=5), PFC (n=4), and thalamostriatal system (n=2) were also commonly modulated. Conclusion Despite proven effectiveness, there has been a dearth of studies investigating the neurobiological mechanisms underlying ECT. There is preliminary evidence of structural and functional modulation of the hippocampus and insula, functional changes in the DMN, PFC, and thalamostriatal system after ECT in patients with schizophrenia. We discuss the rationale and implications of these findings and the potential mechanism of action of ECT. More studies evaluating the mechanisms of ECT are needed, which could provide a unique window into what leads to treatment response in the otherwise refractory TRS population.
#Electroconvulsive therapy #Schizophrenia #Treatment-resistant schizophrenia #Hippocampus #Insula.

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참고문헌 (17)

참고문헌 신청
Uesugi H / 1995 / Positron emission tomography and plasma biochemistry findings in schizophrenic patients before and after electroconvulsive therapy / Psychiatry Clin Neurosci 49:131~135 google schola Escobar R / 2000 / Clinical and cerebral blood flow changes in catatonic patients treated with ECT / J Psychosom Res 49:423~429 google schola Fujita Y / 2011 / Asymmetric alternation of the hemodynamic response at the prefrontal cortex in patients with schizophrenia during electroconvulsive therapy : a near-infrared spectroscopy study / Brain Res 1410:132~140 google schola Gan JL / 2017 / Neuroprotective effect of modified electroconvulsive therapy for schizophrenia / J Nerv Ment Dis 205:480~486 google schola Lotfi M / 2018 / Effect of adjuvant electroconvulsive therapy compared to antipsychotic medication alone on the brain metabolites of patients with chronic schizophrenia : a proton magnetic resonance spectroscopy study / Iran J Psychiatry 13:215~221 google schola

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