Alteration of Functional Connectivity before and after Electroconvulsive Therapy in a Single Patient with Depression and Catatonia
Young-Min Park
Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
Correspondence to: Young-Min Park
Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea
E-mail: medipark@hanmail.net
ORCID: https://orcid.org/0000-0002-4993-1426
Received: May 1, 2023; Revised: May 28, 2023; Accepted: May 31, 2023; Published online: July 12, 2023.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Catatonia, a severe neuropsychiatric condition, is distinguished by a range of prominent motor features such as immobility, mutism, negativism, rigidity, posturing, staring, stereotypy, automatic obedience, echolalia, and mannerism. A female patient of middle age was admitted to the open psychiatric ward of a hospital after exhibiting suicidal ideation, delusions, depression, insomnia, refusal to eat, difficulty in swallowing, and decreased motivation for four months prior to admission. Following 14 electroconvulsive therapy (ECT) sessions, her symptoms improved in the order of appetite, immobility, speech volume, mood, and delusions. The post-ECT functional connectivity was found to be improved compared to pre-ECT. The patient was discharged to outpatient clinics with medications that included aripiprazole, mirtazapine, quetiapine, and trazodone. This case reveals that ECT is an efficacious treatment in a depressive patient with catatonia, with movement symptoms responding to ECT more rapidly than affective symptoms. In addition to the improvement of movement and affective symptoms, functional connectivity much improved after ECT.
Keywords: Catatonia; Major depressive disorder; Functional connectivity; Electroconvulsive therapy; EEG

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