Mechanism of Action of Electroconvulsive Therapy

This project aims to use functional connectivity magnetic resonance imaging (fcMRI) to study patients with unipolar and bipolar depression receiving ECT. Patients will be scanned before and after a full course of ECT and clinical measures for depression severity and memory will be obtained at the same times.The project has the following aims and hypothesis: (1) to determine the therapeutic antidepressant mechanism of action of ECT at the circuit level (2) to determine the mechanism of action of iatrogenic amnesia caused by ECT at the circuit level (3) to study the use of fcMRI as a state biomarker for depression (4) to study the use of fcMRI as a predictor of response for depression.

Inclusion criteria

• Males and Females Between Ages of 18 and 65
• Diagnosis of Major Depressive Disorder without Psychotic Features or Bipolar I/II
• Requiring ECT Treatment as Part of Psychiatric Care

Exclusion criteria

• Comorbid diagnoses of Major Depressive Disorder with Psychotic Features, Schizoaffective Disorder, Schizophrenia or Dementia
• History of Psychosis
• Substance Use Disorder (Abuse or Dependence) with Active Use Within Last 6 Months
• Severe or Unstable Medical Illness
• Medical Contraindication to Anesthesia or ECT (e.g., Recent Myocardial Infarction)