Brain Changes Induced by Electroconvulsive Therapy Are Broadly Distributed

GEMRIC

doi:10.1016/j.biopsych.2019.07.010

Brain Changes Induced by Electroconvulsive Therapy Are Broadly Distributed

GEMRIC

Department of Clinical Medicine

18 Citations (Scopus)

Abstract

Background: Electroconvulsive therapy (ECT) is associated with volumetric enlargements of corticolimbic brain regions. However, the pattern of whole-brain structural alterations following ECT remains unresolved. Here, we examined the longitudinal effects of ECT on global and local variations in gray matter, white matter, and ventricle volumes in patients with major depressive disorder as well as predictors of ECT-related clinical response. Methods: Longitudinal magnetic resonance imaging and clinical data from the Global ECT-MRI Research Collaboration (GEMRIC) were used to investigate changes in white matter, gray matter, and ventricle volumes before and after ECT in 328 patients experiencing a major depressive episode. In addition, 95 nondepressed control subjects were scanned twice. We performed a mega-analysis of single subject data from 14 independent GEMRIC sites. Results: Volumetric increases occurred in 79 of 84 gray matter regions of interest. In total, the cortical volume increased by mean ± SD of 1.04 ± 1.03% (Cohen's d = 1.01, p < .001) and the subcortical gray matter volume increased by 1.47 ± 1.05% (d = 1.40, p < .001) in patients. The subcortical gray matter increase was negatively associated with total ventricle volume (Spearman's rank correlation ρ = −.44, p < .001), while total white matter volume remained unchanged (d = −0.05, p = .41). The changes were modulated by number of ECTs and mode of electrode placements. However, the gray matter volumetric enlargements were not associated with clinical outcome. Conclusions: The findings suggest that ECT induces gray matter volumetric increases that are broadly distributed. However, gross volumetric increases of specific anatomically defined regions may not serve as feasible biomarkers of clinical response.

Original language	English
Journal	Biological Psychiatry
ISSN	0006-3223
DOIs	https://doi.org/10.1016/j.biopsych.2019.07.010
Publication status	Published - 1 Mar 2020

Keywords

Antidepressant
Biomarker
Brain
Depression
ECT
Magnetic resonance imaging
Neuroimaging

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10.1016/j.biopsych.2019.07.010

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@article{dbdf3d5a84c84f87bf8c9c62c1ffe46d,

title = "Brain Changes Induced by Electroconvulsive Therapy Are Broadly Distributed",

abstract = "Background: Electroconvulsive therapy (ECT) is associated with volumetric enlargements of corticolimbic brain regions. However, the pattern of whole-brain structural alterations following ECT remains unresolved. Here, we examined the longitudinal effects of ECT on global and local variations in gray matter, white matter, and ventricle volumes in patients with major depressive disorder as well as predictors of ECT-related clinical response. Methods: Longitudinal magnetic resonance imaging and clinical data from the Global ECT-MRI Research Collaboration (GEMRIC) were used to investigate changes in white matter, gray matter, and ventricle volumes before and after ECT in 328 patients experiencing a major depressive episode. In addition, 95 nondepressed control subjects were scanned twice. We performed a mega-analysis of single subject data from 14 independent GEMRIC sites. Results: Volumetric increases occurred in 79 of 84 gray matter regions of interest. In total, the cortical volume increased by mean ± SD of 1.04 ± 1.03% (Cohen's d = 1.01, p < .001) and the subcortical gray matter volume increased by 1.47 ± 1.05% (d = 1.40, p < .001) in patients. The subcortical gray matter increase was negatively associated with total ventricle volume (Spearman's rank correlation ρ = −.44, p < .001), while total white matter volume remained unchanged (d = −0.05, p = .41). The changes were modulated by number of ECTs and mode of electrode placements. However, the gray matter volumetric enlargements were not associated with clinical outcome. Conclusions: The findings suggest that ECT induces gray matter volumetric increases that are broadly distributed. However, gross volumetric increases of specific anatomically defined regions may not serve as feasible biomarkers of clinical response.",

keywords = "Antidepressant, Biomarker, Brain, Depression, ECT, Magnetic resonance imaging, Neuroimaging",

author = "Ousdal, {Olga Therese} and Miklos Argyelan and Narr, {Katherine L.} and Christopher Abbott and Benjamin Wade and Mathieu Vandenbulcke and Mikel Urretavizcaya and Indira Tendolkar and Akihiro Takamiya and Stek, {Max L.} and Carles Soriano-Mas and Ronny Redlich and Paulson, {Olaf B.} and Oudega, {Mardien L.} and Nils Opel and Pia Nordanskog and Taishiro Kishimoto and Robin Kampe and Anders J{\o}rgensen and Hanson, {Lars G.} and Hamilton, {J. Paul} and Randall Espinoza and Louise Emsell and {van Eijndhoven}, Philip and Annemieke Dols and Udo Dannlowski and Narcis Cardoner and Filip Bouckaert and Amit Anand and Hauke Bartsch and Ute Kessler and Oedegaard, {Ketil J.} and Dale, {Anders M.} and Leif Oltedal and Erchinger, {Vera Jane} and Jan Haavik and {Evjenth S{\o}rhaug}, {Ole Johan} and J{\o}rgensen, {Martin B.} and Bolwig, {Tom G.} and Peter Magnusson and Marta Cano and Jes{\'u}s Pujol and Mench{\'o}n, {Jos{\'e} M.} and Georgios Petrides and Pascal Sienaert and GEMRIC",

year = "2020",

month = mar,

day = "1",

doi = "10.1016/j.biopsych.2019.07.010",

language = "English",

journal = "Biological Psychiatry",

issn = "0006-3223",

publisher = "Elsevier",

}

TY - JOUR

T1 - Brain Changes Induced by Electroconvulsive Therapy Are Broadly Distributed

AU - Ousdal, Olga Therese

AU - Argyelan, Miklos

AU - Narr, Katherine L.

AU - Abbott, Christopher

AU - Wade, Benjamin

AU - Vandenbulcke, Mathieu

AU - Urretavizcaya, Mikel

AU - Tendolkar, Indira

AU - Takamiya, Akihiro

AU - Stek, Max L.

AU - Soriano-Mas, Carles

AU - Redlich, Ronny

AU - Paulson, Olaf B.

AU - Oudega, Mardien L.

AU - Opel, Nils

AU - Nordanskog, Pia

AU - Kishimoto, Taishiro

AU - Kampe, Robin

AU - Jørgensen, Anders

AU - Hanson, Lars G.

AU - Hamilton, J. Paul

AU - Espinoza, Randall

AU - Emsell, Louise

AU - van Eijndhoven, Philip

AU - Dols, Annemieke

AU - Dannlowski, Udo

AU - Cardoner, Narcis

AU - Bouckaert, Filip

AU - Anand, Amit

AU - Bartsch, Hauke

AU - Kessler, Ute

AU - Oedegaard, Ketil J.

AU - Dale, Anders M.

AU - Oltedal, Leif

AU - Erchinger, Vera Jane

AU - Haavik, Jan

AU - Evjenth Sørhaug, Ole Johan

AU - Jørgensen, Martin B.

AU - Bolwig, Tom G.

AU - Magnusson, Peter

AU - Cano, Marta

AU - Pujol, Jesús

AU - Menchón, José M.

AU - Petrides, Georgios

AU - Sienaert, Pascal

AU - GEMRIC

PY - 2020/3/1

Y1 - 2020/3/1

N2 - Background: Electroconvulsive therapy (ECT) is associated with volumetric enlargements of corticolimbic brain regions. However, the pattern of whole-brain structural alterations following ECT remains unresolved. Here, we examined the longitudinal effects of ECT on global and local variations in gray matter, white matter, and ventricle volumes in patients with major depressive disorder as well as predictors of ECT-related clinical response. Methods: Longitudinal magnetic resonance imaging and clinical data from the Global ECT-MRI Research Collaboration (GEMRIC) were used to investigate changes in white matter, gray matter, and ventricle volumes before and after ECT in 328 patients experiencing a major depressive episode. In addition, 95 nondepressed control subjects were scanned twice. We performed a mega-analysis of single subject data from 14 independent GEMRIC sites. Results: Volumetric increases occurred in 79 of 84 gray matter regions of interest. In total, the cortical volume increased by mean ± SD of 1.04 ± 1.03% (Cohen's d = 1.01, p < .001) and the subcortical gray matter volume increased by 1.47 ± 1.05% (d = 1.40, p < .001) in patients. The subcortical gray matter increase was negatively associated with total ventricle volume (Spearman's rank correlation ρ = −.44, p < .001), while total white matter volume remained unchanged (d = −0.05, p = .41). The changes were modulated by number of ECTs and mode of electrode placements. However, the gray matter volumetric enlargements were not associated with clinical outcome. Conclusions: The findings suggest that ECT induces gray matter volumetric increases that are broadly distributed. However, gross volumetric increases of specific anatomically defined regions may not serve as feasible biomarkers of clinical response.

AB - Background: Electroconvulsive therapy (ECT) is associated with volumetric enlargements of corticolimbic brain regions. However, the pattern of whole-brain structural alterations following ECT remains unresolved. Here, we examined the longitudinal effects of ECT on global and local variations in gray matter, white matter, and ventricle volumes in patients with major depressive disorder as well as predictors of ECT-related clinical response. Methods: Longitudinal magnetic resonance imaging and clinical data from the Global ECT-MRI Research Collaboration (GEMRIC) were used to investigate changes in white matter, gray matter, and ventricle volumes before and after ECT in 328 patients experiencing a major depressive episode. In addition, 95 nondepressed control subjects were scanned twice. We performed a mega-analysis of single subject data from 14 independent GEMRIC sites. Results: Volumetric increases occurred in 79 of 84 gray matter regions of interest. In total, the cortical volume increased by mean ± SD of 1.04 ± 1.03% (Cohen's d = 1.01, p < .001) and the subcortical gray matter volume increased by 1.47 ± 1.05% (d = 1.40, p < .001) in patients. The subcortical gray matter increase was negatively associated with total ventricle volume (Spearman's rank correlation ρ = −.44, p < .001), while total white matter volume remained unchanged (d = −0.05, p = .41). The changes were modulated by number of ECTs and mode of electrode placements. However, the gray matter volumetric enlargements were not associated with clinical outcome. Conclusions: The findings suggest that ECT induces gray matter volumetric increases that are broadly distributed. However, gross volumetric increases of specific anatomically defined regions may not serve as feasible biomarkers of clinical response.

KW - Antidepressant

KW - Biomarker

KW - Brain

KW - Depression

KW - ECT

KW - Magnetic resonance imaging

KW - Neuroimaging

U2 - 10.1016/j.biopsych.2019.07.010

DO - 10.1016/j.biopsych.2019.07.010

M3 - Journal article

C2 - 31561859

AN - SCOPUS:85072586816

SN - 0006-3223

JO - Biological Psychiatry

JF - Biological Psychiatry

ER -

Brain Changes Induced by Electroconvulsive Therapy Are Broadly Distributed

Abstract

Keywords

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