Characterization of gray matter volume changes from one week to 6 months after termination of electroconvulsive therapy in depressed patients

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  • Maarten Laroy
  • Filip Bouckaert
  • Olga Therese Ousdal
  • Annemieke Dols
  • Didi Rhebergen
  • Eric van Exel
  • Guido van Wingen
  • Jeroen van Waarde
  • Joey Verdijk
  • Ute Kessler
  • Hauke Bartsch
  • Jørgensen, Martin Balslev
  • Paulson, Olaf B.
  • Pia Nordanskog
  • Joan Prudic
  • Pascal Sienaert
  • Mathieu Vandenbulcke
  • Leif Oltedal
  • Louise Emsell
  • for GEMRIC

Background: Increased gray matter volume (GMV) following electroconvulsive therapy (ECT) has been well-documented, with limited studies reporting a subsequent decrease in GMV afterwards. Objective: This study characterized the reversion pattern of GMV after ECT and its association with clinical depression outcome, using multi-site triple time-point data from the Global ECT-MRI Research Collaboration (GEMRIC). Methods: 86 subjects from the GEMRIC database were included, and GMV in 84 regions-of-interest (ROI) was obtained from automatic segmentation of T1 MRI images at three timepoints: pre-ECT (T0), within one-week post-ECT (T1), and one to six months post-ECT (T2). RM-ANOVAs were used to assess longitudinal changes and LMM analyses explored associations between GMV changes and demographical and clinical characteristics. Results: 63 of the 84 ROIs showed a significant increase-and-decrease pattern (RM-ANOVA, Bonferroni corrected p < 0.00059). Post hoc tests indicated a consistent pattern in each of these 63 ROIs: significant increase from T0 to T1inGMV, followed by significant decrease from T1 to T2 and no difference between T0 and T2, except for both amygdalae, right hippocampus and pars triangularis, which showed the same increase and decrease but GMV at T2 remained higher compared to T0. No consistent relationship was found between GMV change pattern and clinical status. Conclusion: The GEMRIC cohort confirmed a rapid increase of GMV after ECT followed by reversion of GMV one to six months thereafter. The lack of association between the GMV change pattern and depression outcome scores implies a transient neurobiological effect of ECT unrelated to clinical improvement.

OriginalsprogEngelsk
TidsskriftBrain Stimulation
Vol/bind17
Udgave nummer4
Sider (fra-til)876-886
Antal sider11
ISSN1935-861X
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
To date, multiple studies, including those originating from the Global ECT-MRI Research Collaboration (GEMRIC), provide support for widespread and robust gray matter volume (GMV) increase after ECT [10, 12\u201315]. However, most of the attention is directed towards the initial increase in GMV and its possible relation with mood, cognitive, technical or electrical field correlates [10, 16\u201323]. The majority of these studies fail to identify significant associations between the initial GMV increase within a few weeks after the ECT-course and the investigated clinical correlates [14,18,23]. However, there is more to the GMV changes than the initial volume increase. A small number of studies included a follow-up timepoint of the post-index ECT phase in their experimental design and provided preliminary evidence that the initial GMV increase reverts after termination of the initial ECT-course [16,24\u201331] (Table 1).M. Laroy is an aspirant researcher for the Research Foundation Flanders (FWO, grant no. 1168821 N). M. Vandenbulcke, F. Bouckaert, L. Emsell received funding from KU Leuven Research Fund C24/18/095 and KU Leuven Sequoia Fund for Research on Aging and Mental Health. L. Oltedal received funding from Western Norway Regional Health Authority Grant (No. 912238).O. Paulson and M.B. Jorgensen received support from the Lundbeck Foundation. All other individually named co-authors in the GEMRIC working group declared no financial interests or potential conflicts of interest. None of the reported funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report.M. Laroy is an aspirant researcher for the Research Foundation Flanders (FWO, grant no. 1168821 N). M. Vandenbulcke, F. Bouckaert, L. Emsell received funding from KU Leuven Research Fund C24/18/095 and KU Leuven Sequoia Fund for Research on Aging and Mental Health. L. Oltedal received funding from Western Norway Regional Health Authority Grant (No. 912238). O. Paulson and M.B. Jorgensen received support from the Lundbeck Foundation.

Funding Information:
M. Laroy is an aspirant researcher for the Research Foundation Flanders (FWO, grant no. 1168821 N). M. Vandenbulcke, F. Bouckaert, L. Emsell received funding from KU Leuven Research Fund C24/18/095 and KU Leuven Sequoia Fund for Research on Aging and Mental Health. L. Oltedal received funding from Western Norway Regional Health Authority Grant (No. 912238).

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