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Electroconvulsive therapy-induced brain plasticity determines therapeutic outcome in mood disorders

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Dukart,  Jürgen
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;
Laboratoire de Recherche en Neuroimagerie (LREN), Centre hospitalier universitaire vaudois, Lausanne, Switzerland;

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Draganski,  Bogdan
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;
Laboratoire de Recherche en Neuroimagerie (LREN), Centre hospitalier universitaire vaudois, Lausanne, Switzerland;

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Citation

Dukart, J., Regen, F., Khefir, F., Colla, M., Bajbouj, M., Heuser, I., et al. (2014). Electroconvulsive therapy-induced brain plasticity determines therapeutic outcome in mood disorders. Proceedings of the National Academy of Sciences of the United States of America, 111(3), 1156-1161. doi:10.1073/pnas.1321399111.


Cite as: http://hdl.handle.net/11858/00-001M-0000-0015-83DA-5
Abstract
There remains much scientific, clinical, and ethical controversy concerning the use of electroconvulsive therapy (ECT) for psychiatric disorders stemming from a lack of information and knowledge about how such treatment might work, given its nonspecific and spatially unfocused nature. The mode of action of ECT has even been ascribed to a “barbaric” form of placebo effect. Here we show differential, highly specific, spatially distributed effects of ECT on regional brain structure in two populations: patients with unipolar or bipolar disorder. Unipolar and bipolar disorders respond differentially to ECT and the associated local brain-volume changes, which occur in areas previously associated with these diseases, correlate with symptom severity and the therapeutic effect. Our unique evidence shows that electrophysical therapeutic effects, although applied generally, take on regional significance through interactions with brain pathophysiology.