Multimodal Imaging of ECT Effects
Condition: Major Depressive Disorder
MeSH terms: Depressive Disorder; Depressive Disorder, Major
Study type: Observational [Patient Registry]

Summary: 
      The project aims to investigate markers of neural activity and connectivity, neurochemistry,
      hypothalamic-pituitary-adrenal (HPA) axis activity, inflammation and neuronal plasticity
      underlying treatment response and remission after ECT. These measures will be assessed in
      depressive patients prior, during and after ECT and also after 6 months. Furthermore, we will
      investigate a control group of depressive patients treated with antidepressants.
    

Detailed description: 
      About 30% of patients suffering from major depressive disorder (MDD) do not respond
      sufficiently to established pharmacological, psychotherapeutic, or somatic treatment.
      Treatment-resistant MDD is associated with illness chronicity, a reduced quality of life, and
      a higher risk for suicide. For these patients, electroconvulsive therapy (ECT) is a
      well-established treatment strategy with response rates of 60% to 80%, making it the most
      potent and rapidly acting treatment for MDD. Despite the frequent and widespread use of ECT
      for more than 70 years, the exact neurobiological mechanisms underlying its efficacy remain
      unclear. In a broader sense, understanding the therapeutic effects of ECT may also shed some
      more light on the pathophysiological causes of severe depression and the mechanisms of action
      of an effective treatment. Eventually, the elucidation of the effects of ECT could allow for
      their reproduction in a less invasive way and with a more benign side-effect profile, thereby
      resulting in an significantly enhanced treatment of MDD. To achieve this, though, we need
      first to understand better how ECT influences brain function. The proposed project therefore
      aims to investigate markers of neural activity and connectivity, neurochemistry, HPA axis
      activity, inflammation and neuronal plasticity underlying treatment response and remission
      after ECT. These measures will be assessed in depressive patients prior, during and after ECT
      and also after 6 months. Furthermore, we will investigate a control group of depressive
      patients treated with antidepressants. This treatment-specific approach will enable us to
      disentangle which behavioral, neuronal, hormonal and immunological alterations are crucial
      for an antidepressant response and might be used for response prediction. More generally, the
      project will greatly broaden our understanding of the mechanisms underlying the profound
      antidepressant effect of ECT and thereby shed some more light on the pathophysiological
      causes of MDD and the mechanisms of action of an effective treatment.
    

Intervention name(s): electroconvulsive therapy; Antidepressant
Intervention type(s): Procedure; Drug
Intervention description(s): electroconvulsive therapy; Antidepressant
Intervention MeSH terms: Antidepressive Agents
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Depressive patients from a primary care clinic
      
Biospecimen description: 
      whole blood