Brain Changes in Severely Depressed Patients Before and After Treatment With Electroconvulsive Therapy
- Conditions
- Severe Depression
- Interventions
- Device: 3T MRI
- Registration Number
- NCT02715986
- Lead Sponsor
- University Hospital, Toulouse
- Brief Summary
Electroconvulsive therapy (ECT) is a non-pharmacological treatment used in resistant depression whose effectiveness has been demonstrated. However, the brain mechanisms underlying this therapeutic effect remain unclear. Many animal studies show a neurotrophic action of ECT on the hippocampus: increased neurogenesis, synaptogenesis, proliferation of glial cells. In addition, functional imaging of "resting state" type have shown, among depressed patients after ECT, increased functional connectivity . These results were reinforced by the recent work of Perrin (2012). In view of this a priori contradictory, it seems appropriate to continue research neuroanatomical correlates subtending neurofunctional processes responsible at the same time improving the clinical depressive. The investigators suggest using an original technique never used in this type of population: Functional magnetic resonance imaging (fMRI) or multimodal structural-functional. This method will allow us to study the impact of ECT on brain structures involved in major depressive disorder: hippocampus.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 17
- diagnostic and Statistical Manual of Mental Disorders-V (DSM) diagnosis of major depressive disorder
- indication of ECT and signing the consent for conducting a ECT
- right-handed
- be of French mother tongue
- belong to a social security scheme
- sign an informed consent
- against indication for MRI
- against indication to anesthesia
- processes brain expensive
- pregnant woman
- refuse to be informed of an abnormality detected during MRI
- Patients holders of stimulation electrodes
- presence history of neurological disease
- presence history of head injury
- Mini-Mental State Examination (MMSE) <15/30
- presence of neurodegenerative disease
- patients who have had ECT treatment in the last 6 months
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Severly depressed patients 3T MRI Recruitment of twenty depressive subjects will be conducted within the hospital service adult psychiatry.These patients are referred for indication of ECT sessions for severe resistant depression. Four MRI evaluations (3T MRI examination) are programmed in such patients to analyze structural changes in the hippocampus.
- Primary Outcome Measures
Name Time Method Morphological changes in the hippocampus between baseline and after the first ECT effective session as assessed by volume measure in multimodal MRI. Within 48 hours after the first effective ECT session. Visit 3 will take place within 48 hours after the first ECT session effective.
- Secondary Outcome Measures
Name Time Method Functional connectivity changes of the hippocampus-related networks between baseline and after the first effective ECT session as assessed by measure of connectivity in multimodal MRI. Within 48 hours after the first effective ECT session. Visit 3 will take place within 48 hours after the first ECT session effective.
Morphological changes of the hippocampus-related networks between baseline and after the first ECT session as assessed by measure of volume in multimodal MRI. Within 48 hours after the first ECT session. Visit 2 will take place within 48 hours after the first ECT session
Morphological changes of the hippocampus-related networks between baseline and after the first ECT session as assessed by average diffusivity in multimodal MRI. Within 48 hours after the first ECT session. Visit 2 will take place within 48 hours after the first ECT session
Functional changes of the hippocampal-related networks between baseline and after the first ECT session as assessed by measure of connectivity in multimodal MRI. Within 48 hours after the first ECT session. Visit 2 will take place within 48 hours after the first ECT session
Morphological changes in the hippocampus and hippocampal-related networks related to ECT between baseline and after remission as assessed by Within 10 days after remission. Remission is defined by a score of 7 or less on Hamilton Depression Rating
Morphological changes in the hippocampus and hippocampal-related networks related to ECT between baseline and after remission as assessed by measure of volume in multimodal MRI Within 10 days after remission. Remission is defined by a score of 7 or less on Hamilton Depression Rating
Functional changes in the hippocampus and hippocampal-related networks related to ECT after remission as assessed by measure of connectivity in multimodal MRI. Within 10 days after remission Remission is defined by a score of 7 or less on Hamilton Depression Rating Scale (HDRS).
Changes in the intensity of depressive symptoms score (Hamilton Depression Rating Scale) after the first ECT, ECT first "effective" and after remission Within 7 days before first ECT, after the first ECT, within 48 hours after the first effective ECT and within 10 days after remission Hamilton Depression Rating Scale will be realised during all visits, after ECT.
Evolution of Real Life/Real Impact-16 (RLRI-16) score after the first ECT, after ECT first "effective" and after remission Within 7 days before first ECT, after the first ECT, within 48 hours after the first effective ECT and within 10 days after remission RLRI-16 test will be realised during all visits, after ECT.
Trial Locations
- Locations (1)
CHU Toulouse, Hôpital de psychiatrie
🇫🇷Toulouse, France