Electroconvulsive therapy modulates Fronto-temporal functional connectivity in adolescents with depression and suicidal ideation

Objective: We aimed to investigate changes in whole-brain functional connectivity (FC) before and after electroconvulsive therapy (ECT) in adolescents with major depressive disorder (MDD) and suicidal ideation (SI). Methods: Forty-nine adolescents with MDD and SI were enrolled, and resting-state functional magnetic resonance imaging (rs-fMRI) was performed at baseline and after ECT for each patient. Forty healthy controls (HCs) were scanned only at baseline. Region-of-interest (ROI)-based whole-brain FC analyses were used, with the left superior frontal gyrus (L-SFG) and right superior temporal gyrus (R-STG) as seed regions. Results: Compared with HCs, MDD patients at baseline showed decreased FC between R-STG and left inferior occipital gyrus (L-IOG), and between L-SFG and right anterior cingulate gyrus (R-ACG). After ECT, MDD patients showed reduced FC between R-STG and right middle temporal gyrus (R-MTG), increased FC between L-SFG and right middle frontal gyrus (R-MFG), and decreased FC between L-SFG and right superior occipital gyrus (R-SOG)/right superior frontal gyrus (R-SFG). Pearson's correlation found that post-ECT Hamilton Depression Rating Scale-17 (HAMD-17) scores were negatively correlated with FC between R-STG and L-IOG. Conclusion: Abnormal FC in the frontal-cingulate and frontal-temporal circuits may be a potential neurobiological basis of depressive and suicidal symptoms in adolescents. ECT may improve these symptoms by modulating FC in these key brain regions.