Nodal degree changes induced by electroconvulsive therapy in major depressive disorder: Evidence in two independent cohorts.

Electroconvulsive therapy (ECT), a rapidly acting treatment for major depressive disorder (MDD), has been reported to regulate brain networks. Nodes and their connections are the main components of the brain network and are essential for establishing and maintaining effective information transmission. This study aimed to evaluate the role of nodes in mediating antidepressant effects of ECT. Voxel-based nodal degree analysis was performed in 42 patients with MDD receiving ECT and 42 matched healthy controls at two time points to identify the nodal changes induced by ECT. Verification analysis was evaluated in a second, independent cohort of 23 MDD patients. MDD patients showed improved nodal degree of the bilateral angular cortex (AG), precuneus, inferior frontal gyrus (IFG) and the right superior frontal gyrus (SFG) after ECT, and the increased nodal degree index (IND) rate of the AG and precuneus were negatively correlated to the depressive changes following ECT. Furthermore, validation analysis revealed a similar pattern of IND abnormalities in the first and second cohort of MDD patients. ECT regulates the disrupted nodal degree of the AG and precuneus to achieve an antidepressant effect. This study may provide further insights into the pathogenesis of depression and provide potential targets for antidepressant pharmacotherapies.

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