Depressive rumination has been implicated in the onset, duration, and treatment response of refractory depression. Electroconvulsive therapy (ECT) is remarkably effective in treatment of refractory depression by modulating the functional coordination between brain hubs. However, the mechanisms by which ECT regulates depressive rumination remain unsolved. We investigated degree centrality (DC) in 32 pre- and post-ECT depression patients as well as 38 matched healthy controls. An identified brain region was defined as the seed to calculate functional connectivity (FC) in whole brains. Rumination was measured by the Ruminative Response Scale (RRS) and its relationships with identified DC and FC alterations were examined. We found a significant negative correlation between DC of the right orbitofrontal cortex (rOFC) before ECT and brooding level before and after treatment. Moreover, rOFC DC increased after ECT. DC of the left superior temporal gyrus (lSTG) was positively correlated with reflective level before intervention, while lSTG DC decreased after ECT. Patients showed elevated FC in the rOFC with default mode network. No significant association was found between decreased RRS scores and changes in DC and FC. Our findings suggest that functional changes in rOFC and lSTG may be associated with the beneficial effects of ECT on depressive rumination.

抑郁性沉思与难治性抑郁症的发病、持续时间和治疗反应有关。电休克疗法（ECT）通过调节大脑中枢之间的功能协调来治疗难治性抑郁症，效果显着。然而，ECT 调节抑郁性沉思的机制仍未解决。我们调查了 32 名接受 ECT 治疗前和治疗后的抑郁症患者以及 38 名匹配的健康对照者的程度中心性 (DC)。确定的大脑区域被定义为计算整个大脑功能连接（FC）的种子。反刍通过反刍反应量表（RRS）进行测量，并检查其与已识别的 DC 和 FC 改变的关系。我们发现ECT前右眶额皮质（rOFC）的DC与治疗前后的育雏水平之间存在显着的负相关。此外，ECT 后 rOFC DC 增加。干预前左颞上回（lSTG）的 DC 与反射水平呈正相关，而 ECT 后 lSTG DC 下降。患者在默认模式网络的 rOFC 中表现出 FC 升高。 RRS 评分降低与 DC 和 FC 变化之间没有发现显着关联。我们的研究结果表明，rOFC 和 lSTG 的功能变化可能与 ECT 对抑郁性反刍思维的有益作用有关。