Exploring the Impact of Electroconvulsive Therapy on Glymphatic System Function in First-Episode Major Depressive Disorder

Motivation: This study is motivated by the need to understand whether electroconvulsive therapy (ECT) affects the glymphatic system in treating major depressive disorder (MDD). Goal(s): The goal is to determine whether ECT affect the volume of lateral ventricle and choroid plexus, which reflect the glymphatic system. Approach: Using structural MRI, we analyzed volumetric changes between pre- and post-ECT in first-episode, drug-naïve MDD patients. Results: Lateral ventricular volume changes were greater than those in other brain structures and statistically significantly correlated with clinical improvements in MDD following ECT. Impact: This study is the first to demonstrate glymphatic system improvements from ECT, enhancing our understanding of its therapeutic mechanisms in major depressive disorder. These insights could guide more targeted and effective interventions for treating patients with major depression disorders.