A novel approach to investigate the mechanism of electroconvulsive therapy in the treatment of major depression disorder: Diffusion kurtosis imaging.

Background: Major depression disorder (MDD) exhibits a high global incidence; however, its pathogenesis remains elusive. In this prospective study, we employed diffusion kurtosis imaging (DKI) to investigate changes in brain function among patients with MDD both pre- and post-electroconvulsive therapy (ECT).

Methods: We divided a sample of 22 MDD patients into ECT group, which received six treatments over a span of two weeks, and control group (n = 12). DKI scanning was performed before and after treatment. The Hamilton Depression Rating Scale (HAMD) and Life Satisfaction Rating Scale (LSRS) were administered to assess depressive symptoms at baseline, on the 14th day, and at month three.

Results: Significant differences were found between group, time and time × group in terms of HAMD score and LSRS score. In the ECT group compared to pre- ECT measurement, changes in mean diffusivity (MD), fractional Anisotropy (FA), mean kurtosis (MK), radial kurtosis (RK), FA of kurtosis (KA), and anxia kurtosis (AK) value were detected in specific regions such as the frontal, temporal lobe, and hippocampus. In the control group only MD and RK value increased in a limited number of area.

Conclusions: ECT holds the potential to elicit neuroplasticity in the brain, facilitating rapid structural modifications and amelioration of depressive symptoms in patients with MDD.