Winston-Salem,
North Carolina
27157
Purpose:
The purpose of this research is to investigate how the brain changes in patients undergoing
electroconvulsive (ECT) treatment for depression. Subjects will be invited to be in this
study because (1) he/she is a patient about to receive ECT treatment for depression, or (2)
he/she is a healthy adult volunteer with no history of depression.
All volunteers must be between ages 18-70. Participation in this research will involve three
visits. Each visit will last about 4-5 hours. If subject is a patient receiving ECT for
depression the study team will schedule study visits to go along with patient treatment
visits. If subject is a healthy volunteer, visits will occur 1 month and 2 months after the
initial visit.
Participation in this research will involve playing simple computer games while subject's
brain is scanned with magnetic resonance imaging (MRI). Additionally, study team will assess
symptoms of depression using questionnaires. Patients receiving ECT will not experience any
changes to their standard of care ECT treatment plan. Healthy volunteers will not undergo ECT
treatment.
Study summary:
The goal for this study will be to test the following overall hypotheses: (1) that adaptive
decision-making processes are disrupted in patients with treatment-resistant depression, and
(2) the neural and behavioral changes associated with treatment-resistant depression can be
assessed using functional magnetic resonance imaging paired with computationally constrained
adaptive decision-making games.
The investigators will use computational modeling of incentivized decision-making tasks,
brain imaging (functional magnetic resonance imaging, fMRI), and standard clinical
assessments, to characterize patients referred to Wake Forest Baptist Medical Center for ECT.
Characterization will occur over multiple visits to be aligned with the normal course of
patient care.
Data collected may be used in hypothesis driven analyses to:
1. classify treatment resistant depression versus healthy controls
2. predictors of ECT treatment success versus failure
3. characterize brain and behavioral changes consistent with treatment success versus
failure
4. predict who will need maintenance ECT therapy
5. determine what changes in decision-making behavior are apparent in patients who require
ECT maintenance therapy versus those who do not.
Criteria:
For subject volunteers with depression:
Inclusion Criteria:
- Adult volunteers (ages 18-70)
- Patients must meet criteria in standard-of-care evaluation for ECT treatment.
Exclusion Criteria:
- Individuals who cannot have MRI scanning
- Individuals not able to provide written consent and verbal assent
- Individuals not able to understand task instructions or consent documents
- Women who are pregnant
For healthy subject volunteers:
Inclusion Criteria:
- Healthy adult volunteers (ages 18-70)
Exclusion Criteria:
- Individuals diagnosed with depression (regardless of treatment status)
- Individuals who cannot have MRI scanning
- Individuals not able to provide written consent and verbal assent
- Individuals not able to understand task instructions or consent documents
- Women who are pregnant