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Different patterns of temporal variability of functional connectivity to predict response to electroconvulsive therapy in schizophrenia1Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
Synopsis
We aimed to explore the relationship between the pre-treatment temporal variability of resting state functional connectivity and response to electroconvulsive therapy (ECT) in schizophrenia (SZ). Statistical analysis included grouping comparison and Pearson correlation analysis. The grouping comparison of temporal variability between responders to ECT with SZ, non-responders to ECT with SZ and healthy controls were conducted and Pearson correlation analysis was used to reveal the relationship between temporal variability and the response to ECT. The result showed that the temporal variability may serve as a promising indicator to predict the response to ECT in patients with SZ.
Introduction
Electroconvulsive therapy (ECT), causing loss of consciousness and seizures, could treat disease by passing an amount of electric current through the brain. Because of its rapid effect and outstanding efficacy, it has been used in the therapy of schizophrenia (SZ)1,2.However,significant individual differences were shown in the ECT response of SZ patients, which were partly caused by the trait-like differences in brain function and structure among patients. Therefore, it is necessary to explore neurobiological indicators that have the potential to predict the ECT response in SZ. Recent research has revealed that, compared with healthy controls, >20% of brain regions of patients with schizophrenia showed significant differences in temporal variability3.The abnormal pattern of temporal variability in SZ may be related to and predict the efficacy of ECT. Thus, we explored the relationship between pre-treatment temporal variability and ECT response, which may provide a potential indicator for predicting the response to ECT in patients with SZ.Methods
Forty-eight SZ patients with ECT indications and 30 matched healthy controls (HC) underwent clinical evaluation and resting state functional Magnetic Resonance Imaging (rs-fMRI) at baseline. After 4 weeks of ECT treatment, the patients were divided into the responders of schizophrenia (RS, n=23) and non-responders of schizophrenia(NRS, n=25), according to the reduction of positive and negative syndrome scale (ΔPANSS). The temporal variability of anatomical automatic labeling (AAL) atlas-based 90 brain regions was calculated for further analysis. Statistical analysis included grouping comparison and Pearson correlation analysis. The grouping comparison of temporal variability between RS, NRS and HC were conducted and Pearson correlation analysis was used to reveal the relationship between temporal variability and ΔPANSS (Figure 1).Results and discussion
The temporal variability patterns of RS and NRS subgroups were different in the right inferior frontal gyrus, triangular par (IFGtriang.R), left temporal pole,superior temporal gyrus (TPOsup.L) and right middle temporal gyrus (MTG.R). Compared with NRS group and HC group, the variability of IFGtriang.R in RS group was significantly decreased (P < 0.05), and was negatively correlated with ΔPANSS (r = -0.3899, P = 0.0062,Figure 2A). IFG is located in the lateral part of frontal lobe, and its main function is related to language processing, especially semantic processing. The results showed that frontal lobe dysfunction might be the neural basis of SZ, which may affect the efficacy of ECT. The variability of TPOsup.L and MTG.R in NRS group was significantly lower than that in RS group and HC group (P < 0.05), and was positively correlated with ΔPANSS (r = 0.3507, P = 0.0145; r = 0.4333, P = 0.0021,Figure 2B,2C). This suggested that the baseline activity of temporal lobe was related to the efficacy of ECT. The results showed that the temporal variability was a key index to predict the efficacy of ECT in patients with SZ.Conclusion
Different patterns of temporal variability of resting state functional connectivity may serve as a promising indicator for predicting the response to ECT in in patients with SZ.Acknowledgements
This study was supported by Xidian University.References
1.Kellner CH, Obbels J, Sienaert P. When to consider electroconvulsive therapy (ECT). Acta Psychiatr Scand 2019.
2.Xiang YT, Ungvari GS, Correll CU, Chiu HF, Lai KY, Wang CY, et al. Use of electroconvulsive therapy for Asian patients with schizophrenia (2001-2009): Trends and correlates. Psychiatry Clin Neurosci 2015;69(8):489-96.
3.Zhang J, Cheng W, Liu Z, Zhang K, Lei X, Yao Y, et al. Neural, electrophysiological and anatomical basis of brain-network variability and its characteristic changes in mental disorders. Brain 2016;139(Pt 8):2307-21.
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