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Electroconvulsive therapy (ECT) is an efficacious treatment that can alleviate depressive symptoms; however, treatment for pain and the underlying neural substrate is elusive. We enrolled 34 patients with MDD and 33 matched healthy controls to complete clinical assessments and neuroimaging scans. MDD patients underwent second assessments and scans after ECT. We defined a pain\u2010related network with a published meta\u2010analysis and calculated topological patterns to reveal topologic alterations induced by ECT. Using the amplitude of low\u2010frequency fluctuations (ALFFs), we probed local function aberrations of pain\u2010related circuits in MDD patients. Subsequently, we applied gray matter volume (GMV) to reveal structural alterations of ECT relieving pain. The relationships between functional and structural aberrations and pain were determined. ECT significantly alleviated pain. The neural mechanism based on pain\u2010related circuits indicated that ECT weakened the circuit function (ALFF: left amygdala and right supplementary motor area), while augmenting the structure (GMV: bilateral amygdala\/insula\/hippocampus and anterior cingulate cortex). The topologic patterns became less efficient after ECT. Correlation analysis between the change in pain and GMV had negative results in bilateral amygdala\/insula\/hippocampus. Similarity, there was a positive correlation between a change in ALFF in the left amygdala and improved clinical symptoms. ECT improved pain by decreasing brain local function and global network patterns, while increasing structure in pain\u2010related circuits. Functional and structural alterations were associated with improvement in pain.<\/jats:p>","DOI":"10.1002\/jnr.24979","type":"journal-article","created":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T06:39:40Z","timestamp":1637908780000},"page":"477-489","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Functional and structural alterations in the pain\u2010related circuit in major depressive disorder induced by electroconvulsive therapy"],"prefix":"10.1002","volume":"100","author":[{"given":"Ting","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Anhui Medical University  Hefei China"},{"name":"Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders  Hefei China"},{"name":"Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health  Hefei 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