1. Volume of the Human Hippocampus and Clinical Response Following Electroconvulsive Therapy
- Author
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Oltedal, Leif, Narr, Katherine L, Abbott, Christopher, Anand, Amit, Argyelan, Miklos, Bartsch, Hauke, Dannlowski, Udo, Dols, Annemieke, van Eijndhoven, Philip, Emsell, Louise, Erchinger, Vera Jane, Espinoza, Randall, Hahn, Tim, Hanson, Lars G, Hellemann, Gerhard, Jorgensen, Martin Balslev, Kessler, Ute, Oudega, Mardien L, Paulson, Olaf B, Redlich, Ronny, Sienaert, Pascal, Stek, Max L, Tendolkar, Indira, Vandenbulcke, Mathieu, Oedegaard, Ketil J, and Dale, Anders M
- Subjects
Biological Psychology ,Biomedical and Clinical Sciences ,Clinical Sciences ,Psychology ,Mental Health ,Neurosciences ,Depression ,Clinical Research ,Adult ,Aged ,Biomarkers ,Case-Control Studies ,Depressive Disorder ,Major ,Electroconvulsive Therapy ,Female ,Functional Laterality ,Hippocampus ,Humans ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Neuroimaging ,Organ Size ,Psychiatric Status Rating Scales ,Treatment Outcome ,Antidepressant response ,Biomarker ,Brain ,ECT ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Psychiatry ,Biological sciences ,Biomedical and clinical sciences - Abstract
BackgroundHippocampal enlargements are commonly reported after electroconvulsive therapy (ECT). To clarify mechanisms, we examined if ECT-induced hippocampal volume change relates to dose (number of ECT sessions and electrode placement) and acts as a biomarker of clinical outcome.MethodsLongitudinal neuroimaging and clinical data from 10 independent sites participating in the Global ECT-Magnetic Resonance Imaging Research Collaboration (GEMRIC) were obtained for mega-analysis. Hippocampal volumes were extracted from structural magnetic resonance images, acquired before and after patients (n = 281) experiencing a major depressive episode completed an ECT treatment series using right unilateral and bilateral stimulation. Untreated nondepressed control subjects (n = 95) were scanned twice.ResultsThe linear component of hippocampal volume change was 0.28% (SE 0.08) per ECT session (p < .001). Volume change varied by electrode placement in the left hippocampus (bilateral, 3.3 ± 2.2%, d = 1.5; right unilateral, 1.6 ± 2.1%, d = 0.8; p < .0001) but not the right hippocampus (bilateral, 3.0 ± 1.7%, d = 1.8; right unilateral, 2.7 ± 2.0%, d = 1.4; p = .36). Volume change for electrode placement per ECT session varied similarly by hemisphere. Individuals with greater treatment-related volume increases had poorer outcomes (Montgomery-Åsberg Depression Rating Scale change -1.0 [SE 0.35], per 1% volume increase, p = .005), although the effects were not significant after controlling for ECT number (slope -0.69 [SE 0.38], p = .069).ConclusionsThe number of ECT sessions and electrode placement impacts the extent and laterality of hippocampal enlargement, but volume change is not positively associated with clinical outcome. The results suggest that the high efficacy of ECT is not explained by hippocampal enlargement, which alone might not serve as a viable biomarker for treatment outcome.
- Published
- 2018