JOIN USShock treatment can provide an effective alternative for people suffering from major depression who do not respond to conventional medications, researchers, including one of Indian-origin, claim.
Researchers have shown for the first time in a large cohort of patients that electroconvulsive therapy (ECT), sometimes referred to as shock treatment, change certain areas of the brain that play a role in how people feel, learn and respond to positive and negative environmental factors.
The team imaged the hippocampus and amgydala in patients before, during and after undergoing ECT and compared those images to healthy control subjects.
They also showed that the hippocampus changes, or increases in size, correlated to improved mood in patients with major depression and indicated how well they were responding to treatment.
The team showed that parts of these structures change more with treatment, providing vital clues to how the connections in the brain may be used to select for patients who will respond well to treatment.
That would also result in sparing those patients who won't respond from months of taking drugs that ultimately won't work for them, said study senior author Katherine L Narr, an associate professor of neurology at the University of California - Los Angeles Health Sciences.
"Unfortunately, standard types of medication used to treat major depression take a long time to work, and for at least a third of people, the medication will not work well enough to provide any real help," said Narr.
"ECT has been shown to be very effective for treating patients with major depression who don't respond well to other treatments," said study first author Shantanu H Joshi, an assistant professor of neurology.
"During the treatment course, ECT leads to plastic changes in the brain that are linked with improvements in mood. Specifically, we saw the hippocampus and amygdala - important for memory and emotion - are shown to increase in size," said Joshi.
"People with smaller hippocampal size prior to starting treatment are less likely to respond as well to treatment. While our research investigates structural neuroplasticity in depression in response to ECT, our findings are considered to be of much broader interest to the field," Joshi added.
In addition to ECT, the team expects that the effects shown would extend to more standard, less rapidly acting antidepressant treatments and could be used to predict patient response.
In this study, the team imaged 43 patients undergoing ECT at three time points, before beginning treatment, after the second ECT session and within one week of completing treatment, resulting in 129 brain scans.
They also imaged 32 healthy controls twice, and compared those images to the ECT patients.
The study appears in the journal Biological Psychiatry.