Effect of modified electroconvulsive therapy on neuro metabolites and magnetic resonance spectroscopy imaging signals in patients with refractory obsessive-compulsive disorder.

Objective: This study was aimed to investigate the effect of modified electroconvulsive therapy (MECT) on neurometabolites and magnetic resonance spectroscopy imaging (MRSI) signals in patients with refractory obsessive-compulsive disorder (OCD).

Methods: From January 2018 to January 2020, 64 patients with OCD consecutively treated in the Psychiatric Department of our hospital were randomly divided into a study group treated with MECT and a control group treated with drugs alone. The obsessive-compulsive state, anxiety and depression, MRSI signals, neuro metabolite ratio, and quality of life were all observed in both groups.

Results: After treatment, the scores of compulsive behaviors, obsessive thoughts, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) in the study group were lower than those of the control group. The N-acetylaspartate to creatine ratio (NAA/Cr) value was increased in the study group while it was decreased in the control group. In addition, the choline/creatine (Cho/Cr) ratio was decreased in the study group, whereas it was increased in the control group (P < 0.05). Compared to the control group, the study group's social and physiological functions, role limitations, and overall health scores were significantly higher. The amplitudes of low-frequency fluctuations were reduced considerably following MECT treatment in the right anterior cerebellar lobe, left inferior parietal lobule, right paracentral lobule, and right precentral gyrus.

Conclusions: MECT can effectively relieve obsessive-compulsive symptoms, regulate neuro metabolite levels, improve quality of life, reduce anxiety and depression, and is linked to changes in right brain functional activities.