Brain Changes Induced by Electroconvulsive Therapy Are Broadly Distributed

Olga Therese Ousdal; Miklos Argyelan; Katherine L Narr; Christopher Abbott; Benjamin Wade; Mathieu Vandenbulcke; Mikel Urretavizcaya; Indira Tendolkar; Akihiro Takamiya; Max L Stek; Carles Soriano-Mas; Ronny Redlich; Olaf B Paulson; Mardien L Oudega; Nils Opel; Pia Nordanskog; Taishiro Kishimoto; Robin Kampe; Anders Jorgensen; Lars G Hanson; J Paul Hamilton; Randall Espinoza; Louise Emsell; Philip van Eijndhoven; Annemieke Dols; Udo Dannlowski; Narcis Cardoner; Filip Bouckaert; Amit Anand; Hauke Bartsch; Ute Kessler; Ketil J Oedegaard; Anders M Dale; Leif Oltedal; GEMRIC

doi:10.1016/j.biopsych.2019.07.010

Brain Changes Induced by Electroconvulsive Therapy Are Broadly Distributed

Biol Psychiatry. 2020 Mar 1;87(5):451-461. doi: 10.1016/j.biopsych.2019.07.010. Epub 2019 Jul 25.

Authors

Olga Therese Ousdal¹, Miklos Argyelan², Katherine L Narr³, Christopher Abbott⁴, Benjamin Wade³, Mathieu Vandenbulcke⁵, Mikel Urretavizcaya⁶, Indira Tendolkar⁷, Akihiro Takamiya⁸, Max L Stek⁹, Carles Soriano-Mas¹⁰, Ronny Redlich¹¹, Olaf B Paulson¹², Mardien L Oudega⁹, Nils Opel¹³, Pia Nordanskog¹⁴, Taishiro Kishimoto¹⁵, Robin Kampe¹⁴, Anders Jorgensen¹⁶, Lars G Hanson¹⁷, J Paul Hamilton¹⁴, Randall Espinoza³, Louise Emsell⁵, Philip van Eijndhoven¹⁸, Annemieke Dols⁹, Udo Dannlowski¹¹, Narcis Cardoner¹⁹, Filip Bouckaert⁵, Amit Anand²⁰, Hauke Bartsch²¹, Ute Kessler²², Ketil J Oedegaard²², Anders M Dale²³, Leif Oltedal²⁴; GEMRIC

Collaborators

GEMRIC:
Vera Jane Erchinger, Jan Haavik, Ole Johan Evjenth Sørhaug, Martin B Jørgensen, Tom G Bolwig, Peter Magnusson, Marta Cano, Jesús Pujol, José M Menchón, Georgios Petrides, Pascal Sienaert

Affiliations

¹ Department of Radiology, Haukeland University Hospital, Bergen, Norway. Electronic address: [email protected].
² Center for Psychiatric Neuroscience at the Feinstein Institute for Medical Research, New York, New York.
³ Departments of Neurology, Psychiatry, and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles.
⁴ Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico.
⁵ Department of Geriatric Psychiatry, University Psychiatric Center Katholieke Universiteit Leuven, Katholieke Universiteit Leuven, Leuven, Belgium.
⁶ Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain.
⁷ Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands; Donders Institute for Brain Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands; Faculty of Medicine and Landschaftsverband Rheinland Clinic for Psychiatry and Psychotherapy, University of Duisburg-Essen, Duisburg-Essen, Germany.
⁸ Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; Center for Psychiatry and Behavioral Science, Komagino Hospital, Tokyo, Japan.
⁹ Geestelijke GezondheidsZorg inGeest Specialized Mental Health Care, Amsterdam, The Netherlands; Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands.
¹⁰ Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute; Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain.
¹¹ Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany.
¹² Neurobiology Research Unit, Department of Neurology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
¹³ Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany; Interdisciplinary Centre for Clinical Research (IZKF), University of Muenster, Muenster, Germany.
¹⁴ Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
¹⁵ Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
¹⁶ Psychiatric Center Copenhagen (Rigshospitalet), Mental Health Services of the Capital Region of Denmark, Copenhagen, Denmark.
¹⁷ Center for Magnetic Resonance, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark; Danish Research Centre for Magnetic Resonance, Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark.
¹⁸ Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands; Donders Institute for Brain Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands.
¹⁹ Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain; Department of Mental Health, University Hospital Parc Taulí-I3PT, Sabadell, Spain.
²⁰ Cleveland Clinic, Center for Behavioral Health, Cleveland, Ohio.
²¹ Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, California; Department of Radiology, University of California, San Diego, La Jolla, California.
²² Norwegian Centre for Mental Disorders Research, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
²³ Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, California; Department of Radiology, University of California, San Diego, La Jolla, California; Department of Neurosciences, University of California, San Diego, La Jolla, California.
²⁴ Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway.

PMID: 31561859
DOI: 10.1016/j.biopsych.2019.07.010

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.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Brain / diagnostic imaging
Depressive Disorder, Major* / therapy
Electroconvulsive Therapy*
Gray Matter / diagnostic imaging
Humans
Magnetic Resonance Imaging

Abstract

Publication types

MeSH terms

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