최유진 (서울대학교)

한빛사논문

조회235

서울대학교

Mol. Psychiatr., Sep 26 2024, | https://doi.org/10.1038/s41380-024-02755-7 MRI textural plasticity in limbic gray matter associated with clinical response to electroconvulsive therapy for psychosis

Eugenie Choe^1,2,3, Minah Kim^1,2, Sunah Choi⁴, Harin Oh⁴, Moonyoung Jang^1,2, Sunghyun Park¹ and Jun Soo Kwon^5,6,7

¹Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.

²Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.

³Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine, Seoul, Republic of Korea.

⁴Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.

⁵Department of Psychiatry, Hanyang University Hospital, Seoul, South Korea.

⁶Department of Psychiatry, Hanyang University College of Medicine, Seoul, South Korea.

⁷Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea.

Corresponding author

Correspondence to Minah Kim.

Abstract

Electroconvulsive therapy (ECT) is effective against treatment-resistant psychosis, but its mechanisms remain unclear. Conventional volumetry studies have revealed plasticity in limbic structures following ECT but with inconsistent clinical relevance, as they potentially overlook subtle histological alterations. Our study analyzed microstructural changes in limbic structures after ECT using MRI texture analysis and demonstrated a correlation with clinical response. 36 schizophrenia or schizoaffective patients treated with ECT and medication, 27 patients treated with medication only, and 70 healthy controls (HCs) were included in this study. Structural MRI data were acquired before and after ECT for the ECT group and at equivalent intervals for the medication-only group. The gray matter volume and MRI texture, calculated from the gray level size zone matrix (GLSZM), were extracted from limbic structures. After normalizing texture features to HC data, group-time interactions were estimated with repeated-measures mixed models. Repeated-measures correlations between clinical variables and texture were analyzed. Volumetric group-time interactions were observed in seven of fourteen limbic structures. Group-time interactions of the normalized GLSZM large area emphasis of the left hippocampus and the right amygdala reached statistical significance. Changes in these texture features were correlated with changes in psychotic symptoms in the ECT group but not in the medication-only group. These findings provide in vivo evidence that microstructural changes in key limbic structures, hypothetically reflected by MRI texture, are associated with clinical response to ECT for psychosis. These findings support the neuroplasticity hypothesis of ECT and highlight the hippocampus and amygdala as potential targets for neuromodulation in psychosis.

논문정보

형식Research article
게재일2024년 09월 (BRIC 등록일 2024-09-30)
연구진국내 연구진
분야 의약학 > 응용의학

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