Between- and Within-Group Comparisons Before and After Treatment
| Comparison | P value (cluster-corrected) | Voxel of maximal difference* | Regions of higher rCBF (one or more clusters) | Main structures in regions of higher rCBF† |
|---|---|---|---|---|
| Controls vs. all depressed time 1 | <0.001 | −46, 20, −6 | Bilateral frontal (including orbitofrontal, medial, and dorsolateral), temporal, insular, and subcortical gray matter | Anterior cingulate (L), anterior cingulate (R), subcallosal gyrus (L), subcallosal gyrus (R), transverse temporal gyrus (L), transverse temporal gyrus (R), uncus (L), rectal gyrus (L), rectal gyrus (R), insula (L), insula (R), orbital gyrus (L),‡ orbital gyrus (R), precentral gyrus (R), inferior frontal gyrus (L), inferior frontal gyrus (R), postcentral gyrus (R), thalamus (L), caudate (L), caudate (R), amygdala (L), hypothalamus |
| All depressed time 1 vs. controls | NS | |||
| Controls vs. medication responders time 1 | <0.001 | −48, 18, −4 | Bilateral frontal (including medial and dorsolateral), temporal, insular, and subcortical nuclei | Anterior cingulate (L), anterior cingulate (R), subcallosal gyrus (L), subcallosal gyrus (R), rectal gyrus (L), rectal gyrus (R), orbital gyrus (L),‡ orbital gyrus (R), transverse temporal gyrus (L), transverse temporal gyrus (R), insula (L), insula (R), lingual gyrus (R), superior temporal gyrus (L), precentral gyrus (R), inferior frontal gyrus (L), postcentral gyrus (R), thalamus (L), caudate (L), caudate (R), amygdala (L), hypothalamus |
| Medication responders time 1 vs. controls | NS | |||
| Controls vs. ECT responders time 1 | <0.001 | −28, 40, 38 | Bilateral frontal (including orbitofrontal, medial, and dorsolateral), temporal, insular, parietal, and subcortical nuclei | Anterior cingulate (L), anterior cingulate (R), subcallosal gyrus (R), orbital gyrus (R), inferior frontal gyrus (L), inferior frontal gyrus (R), middle frontal gyrus (L), middle frontal gyrus (R),‡ superior frontal gyrus (L), superior frontal gyrus (R), medial frontal gyrus (L), medial frontal gyrus (R), hippocampus (L), amygdala (L), hypothalamus |
| ECT responders time 1 vs. controls | NS | |||
| Depressed time 1 vs. depressed time 2 | NS | |||
| Depressed time 2 vs. depressed time 1 | 0.000 | −6, −68, 60 | Parietal lobe | Superior parietal lobule (L),‡ superior parietal lobule (R), postcentral gyrus (R), medial frontal gyrus (C) |
| All responders time 1 vs. time 2 | NS | |||
| All responders time 2 vs. time 1 | 0.001 | 50, −32, 42 | Right parietal | Postcentral gyrus (R)‡ |
| Medication responders vs. ECT responders, interaction time 1 vs. time 2 | NS | |||
| Medication responders vs. ECT responders, interaction time 2 vs. time 1 | <0.001 | −18, −60, −18 | Bilateral temporal, parietal, occipital, cerebellar | Posterior cingulate (L),‡ posterior cingulate (R), fusiform gyrus (L), fusiform gyrus (R), inferior temporal gyrus (R), lingual gyrus (L), lingual gyrus (R), middle temporal gyrus (L), cuneus (R), supramarginal gyrus (L), precuneus (L), precuneus (R), medial cerebellum (L), medial cerebellum (R), lateral cerebellum (L), lateral cerebellum (R) |
| Medication responders time 1 vs. time 2 | NS | |||
| Medication responders time 2 vs. time 1 | <0.001 | 42, −32, 46 | Bilateral frontal (inferior/dorsolateral), temporal, parietal, occipital, and medial cerebellar | Posterior cingulate (L), posterior cingulate (R), lingual gyrus (L), middle temporal gyrus (L), precentral gyrus (L), precentral gyrus (R), inferior frontal gyrus (L), inferior frontal gyrus (R), dorsolateral prefrontal cortex (L), dorsolateral prefrontal cortex (R), angular gyrus (L), inferior parietal lobule (L), inferior parietal lobule (R), precuneus (L), superior parietal lobule (L), superior parietal lobule (R),‡ paracentral lobule (L), paracentral lobule (R), postcentral gyrus (L), postcentral gyrus (R), medial cerebellum (L), medial cerebellum (R) |
| ECT responders time 1 vs. time 2 | <0.001 | 44, −60, −20 | Bilateral parietotemporal and cerebellar | Posterior cingulate (R), fusiform gyrus (L), fusiform gyrus (R),‡ medial cerebellum (L), medial cerebellum (R), lateral cerebellum (R) |
| ECT responders time 2 vs. time 1 | NS | |||
| Controls vs. ECT responders time 2 | <0.001 | 6, 2, −2 | Bilateral frontal and basal ganglia (including orbitofrontal, medial, and dorsolateral), temporal, insular, parietal, and basal ganglia gray matter | Anterior cingulate (L), anterior cingulate (R), subcallosal gyrus (R), transverse temporal gyrus (L), transverse temporal gyrus (R), rectal gyrus (R), insula (R), precentral gyrus (L), precentral gyrus (R), inferior frontal gyrus (L), inferior frontal gyrus (R), cuneus (R), cingulate gyrus (L), cingulate gyrus (R), middle frontal gyrus (R), paracentral lobule (R), postcentral gyrus (L), postcentral gyrus (R), superior frontal gyrus (L), medial frontal gyrus (L), medial frontal gyrus (R), nodule (R), thalamus (R),‡ caudate (L), caudate (R), hypothalamus |
| 26, −22, 66 | Parietal (R),‡ occipital (R), cerebellar (R) | |||
| ECT responders time 2 vs. controls | NS |
↵* Given by Montreal Neurologic Institute coordinates.
↵† Structures of which more than 30% was included within a significant cluster of voxels.
↵‡ Structure corresponding to Montreal Neurologic Institute voxel of maximal difference.
Time 1 = pretreatment; time 2 = posttreatment; NS = nonsignificant (P > 0.01).
Group sizes: controls, n = 25; all depressed, n = 33; depressed, n = 31 (depressed patients whose imaging data were available for analysis at time 2); all responders, n = 24; medication responders, n = 17; ECT responders, n = 7; nonresponders, n = 7.