Mechanism of Action of Electroconvulsive Therapy

Study Overview
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Brief Summary
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This is an observational neuroimaging study assessing the effects of ECT on the brains of patients with unipolar and bipolar depression.

Detailed Description
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This project aims to use functional connectivity magnetic resonance imaging (fcMRI) to study patients with unipolar and bipolar depression receiving ECT. Patients will be scanned before and after a full course of ECT and clinical measures for depression severity and memory will be obtained at the same times.The project has the following aims and hypothesis: (1) to determine the therapeutic antidepressant mechanism of action of ECT at the circuit level (2) to determine the mechanism of action of iatrogenic amnesia caused by ECT at the circuit level (3) to study the use of fcMRI as a state biomarker for depression (4) to study the use of fcMRI as a predictor of response for depression.

Official Title
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Mechanism of Action of Electroconvulsive Therapy

Conditions
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Unipolar Depression, Bipolar Depression

Intervention / Treatment
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* Procedure: Electroconvulsive Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Males and Females Between Ages of 18 and 65 Diagnosis of Major Depressive Disorder without Psychotic Features or Bipolar I/II Requiring ECT Treatment as Part of Psychiatric Care Exclusion Criteria: Comorbid diagnoses of Major Depressive Disorder with Psychotic Features, Schizoaffective Disorder, Schizophrenia or Dementia History of Psychosis Substance Use Disorder (Abuse or Dependence) with Active Use Within Last 6 Months Severe or Unstable Medical Illness Medical Contraindication to Anesthesia or ECT (e.g., Recent Myocardial Infarction)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Unipolar Depression<br>Patients diagnosed with Major Depressive Disorder. | Procedure: Electroconvulsive Therapy<br>* Electrical currents are passed through the brain to intentionally trigger a controlled seizure in order to produce a therapeutic change in neuro-chemistry and circuitry.<br>|
| Bipolar Depression<br>Patients diagnosed with Bipolar I or II. | Procedure: Electroconvulsive Therapy<br>* Electrical currents are passed through the brain to intentionally trigger a controlled seizure in order to produce a therapeutic change in neuro-chemistry and circuitry.<br>|
| Healthy Control<br>Patients without psychiatric diagnoses. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Functional Connectivity of Key Nodes | Measured by Magnetic Resonance Imaging, Key Nodes include Subgenual Cingulate, Dorsal Anterior Cingulate, Nucleus Accumbens, Hippocampus, Amygdala and Dorsolateral Prefrontal Cortex | Through Treatment Completion, Average of 2 Months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Functional Connectivity of Memory Circuits | Measured by Magnetic Resonance Imaging, Memory Circuits Include Hippocampus and Dorsolateral Prefrontal Memory Hubs | Through Treatment Completion, Average of 2 Months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Electroconvulsive Therapy, Magnetic Resonance Imaging