Investigating the association between electrical cramps therapy and treatment-resistant schizophrenia with changes in brain structure

Oct 16, 2024

The association of changes in MRI texture indicators and symptom severity in the hippocampus and amygdala before and after electroconcussion therapy. Negative correlation was found in both the left hippocampus and the right amygdala. In other words, it was confirmed that the severity of the patient's symptoms tended to ease as the texture index of the area decreased after electrical cramps therapy. Data provision = Seoul National University Hospital

Researchers at Seoul National University Hospital confirmed that 'Electroconvulsive Therapy (ECT)' causes changes in the brain microstructure of treatment-resistant schizophrenia patients, and that this change is related to symptom improvement.

This study provides important clues for understanding the therapeutic mechanisms of electroconcussion therapy and is expected to contribute to the development of treatments in the future.

Schizophrenia is a mental disease accompanied by symptoms such as hearing loss and delusion, and about 30% of patients are treatment-resistant schizophrenia that does not respond to drug treatment. Electrical cramps therapy, which induces convulsions by stimulating the brain, is effective for patients with treatment-resistant schizophrenia. However, the specific treatment mechanism of electroconvulsant therapy has not been clearly identified.

Professor Kim Min-ah of the Department of Mental Health Medicine at Seoul National University Hospital (first author Choi Yu-jin) published the results of a study that analyzed the correlation of electrical cramps therapy on changes in brain gray quality microstructure and symptom severity in treatment-resistant schizophrenia patients using MRI texture analysis techniques.

MRI texture analysis is a precise measurement of microscopic tissue changes that are difficult to detect with conventional brain volume or thickness analysis, and uses GLSZM (Grey Level Size Area Matrix) to evaluate changes in the microstructure of the brain.

The research team took MRIs of 36 patients who received electrical cramps and medication, 27 patients who received only medication, and 70 healthy controls, and compared and analyzed changes in each group.

As a result of the study, the texture index (GLSZM large area empasis) was changed in the left hippocampus and right amygdala in patients who combined electroconvulsive therapy and drug therapy, and this change was significantly correlated with improving the severity of schizophrenia symptoms. This suggests that electrical cramps therapy may play an important role in improving symptoms by inducing microscopic tissue changes in the brain.

In particular, when compared to patients who received only drug treatment, only patients who received electrical convulsion therapy and drug therapy showed significant changes in the texture of brain gray matter. This supports that electrical cramps therapy may play an important role in patients with treatment-resistant schizophrenia.

Choi Yu-jin, the first author, said "This study confirmed that electroconvulsive therapy causes changes in the microstructure of the hippocampus and amygdala, and that this change is related to the improvement of schizophrenia symptoms."This result will contribute to a deeper understanding of the therapeutic mechanisms of electroconcussion therapy"

Professor Kim Min-ah (corresponding author) said, "This study breaks away from the existing extensive brain function control method and further investigates the effects of electroconvulsive therapy on certain key areas of the brain"The results of this study will be used as important basic data for the development of next-generation targeted brain function control techniques."

The findings were published in the recent issue of the international journal `Molecular Psychiatry (IF=9.6).'