Scientists discover structure of adult brain

Brain Connections

Image: Representative map of the compromised connections in the brain. The number of these compounds increased after treatment.
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Credit: Jonathan Repple

Scientists believe that the structure of the adult brain is generally rigid and incapable of rapid change; now new work has shown that this is not true. German researchers have shown that inpatient treatment of depression can lead to an increase in brain connectivity, and patients who respond well to this treatment show a greater increase in connectivity than those who do not.

Presenting the work at the European College for Neuropsychopharmacology Congress in Vienna, lead researcher Professor Jonathan Repple said:

In a response, Dr. Eric Ruhe, Rabdoud University Medical Center, Nijmegen, The Netherlands:

This means that the brain structure of patients with severe clinical depression is not as fixed as we thought, and we can improve the brain structure within a short period of time, about 6 weeks. We found that if this treatment leads to an increase in brain connectivity, it is also effective in addressing depression symptoms. This one gives hope to patients who believe that nothing can change and that they have to live with a disease forever because it is “set in stone” in their brains.

The researchers, working at the University of Münster in Germany, studied 109 patients with major depression (Major Depressive Disorder) and compared them with 55 healthy controls. Their brains were scanned with an MRI scanner set up to identify which parts of the brain were communicating with other parts, determining the level of connections in the brain. The patients were then treated for depression, some with electroconvulsive therapy (ECT), some with psychological therapy or medication, some with a combination of all therapies. After treatment, they were scanned again and the number of connections was added up. They were also retested for symptoms of depression.

Professor Repple (now a professor of predictive psychiatry at the University of Frankfurt) said:

We found that treating depression changed the brain’s infrastructure, which goes against previous expectations. Treated patients showed a greater number of dressings than before treatment. In addition, those who responded most to treatment had developed a greater number of new compounds than those who showed little response. A second scan showing no time effects in healthy controls supports our findings that we are seeing something related to the disease and, most importantly, the treatment of this disease.

We found that these changes happened over a period of only about 6 weeks, we were surprised by the speed of response. We have no explanation for how these changes occur, or why they should happen with such different forms of treatment.”

“This is a very interesting and difficult study in which the authors repeated MRI scans to reveal changes in structural connectivity over time in patients treated for depression.

The results are very much in line with our current belief that the brain has much more flexibility to adapt in (even short) times than previously thought. An important idea of ​​what evokes the treatment of depression (and other psychiatric illnesses) is that plastic changes over time. This has been proposed as a common mechanism for antidepressants, psychotherapy and electroconvulsive therapy. However, the amount of research to elucidate which changes are necessary or specific for treatment response or remission of depression is limited. In addition, the next question is whether different treatments have the ability to alter specifically targeted brain networks or vice versa whether we can use the disturbances in brain networks as measured in the current study to choose which therapy will be helpful.

It is unfortunate that the observed changes over time could not be associated with any form of treatment, but as the authors themselves suggest a topic for further research. First, these results need to be replicated in independent samples, which will hopefully happen soon. A second elaboration of this approach would be daunting and should be strongly supported, as this work could help bridge the current gap between neuroscience and evidence-based patient care.”

This is an independent comment, Dr. Ruhe was not involved in this investigation.

This work is presented at the 35e European College of Neuropsychopharmacology annual conference, taking place in Vienna and online from October 15-18, see A maximum of 5000 delegates are expected. The ECNP is Europe’s leading organization in the field of applied neuroscience.

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