Abstract Electroconvulsive Therapy (ECT) is arguably the most effective intervention for treatment-resistant depression. While large interindividual variability exists, a theory capable of explaining individual response to ECT remains elusive. To address this, we posit a quantitative, mechanistic framework of ECT response based on Network Control Theory (NCT). Then, we empirically test our approach and employ it to predict ECT treatment response. To this end, we derive a formal association between Postictal Suppression Index (PSI)—an ECT seizure quality index—and whole-brain modal and average controllability, NCT metrics based on white-matter brain network architecture, respectively. Exploiting the known association of ECT response and PSI, we then hypothesized an association between our controllability metrics and ECT response mediated by PSI. We formally tested this conjecture in N = 50 depressive patients undergoing ECT. We show that whole-brain controllability metrics based on pre-ECT structural connectome data predict ECT response in accordance with our hypotheses. In addition, we show the expected mediation effects via PSI. Importantly, our theoretically motivated metrics are at least on par with extensive machine learning models based on pre-ECT connectome data. In summary, we derived and tested a control-theoretic framework capable of predicting ECT response based on individual brain network architecture. It makes testable, quantitative predictions regarding individual therapeutic response, which are corroborated by strong empirical evidence. Our work might constitute a starting point for a comprehensive, quantitative theory of personalized ECT interventions rooted in control theory.
The 10Kin1day workshop was generously sponsored by the Neuroscience and Cognition program Utrecht (NCU) of the Utrecht University (https://www.uu.nl/en/research/neuroscience-and-cognition-utrecht), the ENIGMA consortium (http://enigma.ini.usc.edu), and personal grants: MvdH: NWO-VIDI (452-16-015), MQ Fellowship; SB-C: the Wellcome Trust; Medical Research Council UK; NIHR CLAHRC for Cambridgeshire and Peterborough Foundation National Health Services Trust; Autism Research Trust; LB: New Investigator Award, Canadian Institutes of Health Research; Dara Cannon: Health Research Board (HRB), Ireland (grant code HRA-POR-2013-324); SC: Research Grant Council (Hong Kong)-GRF 14101714; Eveline Crone: ERC-2010-StG-263234; UD: DFG, grant FOR2107 DA1151/5-1, DA1151/5-2, SFB-TRR58, Project C09, IZKF, grant Dan3/012/17; SD: MRC-RFA-UFSP-01-2013 (Shared Roots MRC Flagship grant); TF: Marie Curie Programme, International Training Programme, r'Birth; DG: National Science Centre (UMO-2011/02/A/NZ5/00329); BG: National Science Centre (UMO-2011/02/A/NZ5/00329); JH: Western Sydney University Postgraduate Research Award; LH: Science Foundation Ireland, ERC; HH: Research Grant Council (Hong Kong)-GRF 14101714; LJ: Velux Stiftung, grant 369 & UZH University Research Priority Program Dynamics of Healthy Aging; AJ: DFG, grant FOR2107 JA 1890/7-1; KJ: National Science Centre (UMO-2013/09/N/HS6/02634); VK: The Russian Foundation for Basic Research (grant code 15-06-05758 A); TK: DFG, grant FOR2107 KI 588/14-1, DFG, grant FOR2107 KI 588/15-1; AK: DFG, grant FOR2107 KO 4291/4-1, DFG, grant FOR2107 KO 4291/3-1; IL: The Russian Foundation for Basic Research (grant code 15-06-05758 A); EL: Health and Medical Research Fund - 11121271; SiL: NHMRC-ARC Dementia Fellowship 1110414, NHMRC Dementia Research Team Grant 1095127, NHMRC Project Grant 1062319; CL-J: 537-2011, 2014-849; AM: Wellcome Trust Strategic Award (104036/Z/14/Z), MRC Grant MC_PC_17209; CM: Heisenberg-Grant, German Research Foundation, DFG MO 2363/3-2; PM: Foundation for Science and Technology, Portugal - PDE/BDE/113601/2015; KN: National Science Centre (UMO-2011/02/A/NZ5/00329); PN: National Science Centre (UMO-2013/09/N/HS6/02634); JiP: NWO-Veni 451-10-007; PaR: PER and US would like to thank the Schizophrenia Research Institute and the Chief-Investigators of the Australian Schizophrenia Research Bank V. Carr, U. Schall, R. Scott, A. Jablensky, B. Mowry, P. Michie, S. Catts, F. Henskens, and C. Pantelis; AS: National Science Centre (UMO-2011/02/A/NZ5/00329); SS: European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 707730; CS-M: Carlos III Health Institute (PI13/01958), Carlos III Health Institute (PI16/00889), Carlos III Health Institute (CPII16/00048); ES: National Science Centre (UMO-2011/02/A/NZ5/00329); AT: The Russian Foundation for Basic Research (grant code 15-06-05758 A); DT-G: PI14/00918, PI14/00639; Leonardo Tozzi: Marie Curie Programme, International Training Programme, r'Birth; SV: IMPRS Neurocom stipend; TvE: National Center for Research Resources at the National Institutes of Health (grant numbers: NIH 1 U24 RR021992 (Function Biomedical Informatics Research Network), NIH 1 U24 RR025736-01 (Biomedical Informatics Research Network Coordinating Center; http://www.birncommunity.org) and the NIH Big Data to Knowledge (BD2K) award (U54 EB020403 to Paul Thompson). NvH: NWO-VIDI (452-11-014); MW: National Science Centre (UMO-2011/02/A/NZ5/00329); Veronica O'Keane: Meath Foundation; AV and AW: CRC Obesity Mechanism (SFB 1052) Project A1 funded by DFG. The funding sources had no role in the study design, data collection, analysis, and interpretation of the data ; We organized 10Kin1day, a pop-up scientific event with the goal to bring together neuroimaging groups from around the world to jointly analyze 10,000+ existing MRI connectivity datasets during a 3-day workshop. In this report, we describe the motivation and principles of 10Kin1day, together with a public release of 8,000+ MRI connectome maps of the human brain. Ongoing grand-scale projects like the European Human Brain Project (1), the US Brain Initiative (2), the Human Connectome Project (3), the Chinese Brainnetome (4) and exciting world-wide neuroimaging collaborations such as ENIGMA (5) herald the new era of big neuroscience. In conjunction with these major undertakings, there is an emerging trend for bottom-up initiatives, starting with small-scale projects built upon existing collaborations and infrastructures. As described by Mainen et al. (6), these initiatives are centralized around self-organized groups of researchers working on the same challenges and sharing interests and specialized expertise. These projects could scale and open up to a larger audience and other disciplines over time, eventually lining up and merging their findings with other programs to make the bigger picture.