Electroconvulsive therapy induced gray matter increase is not necessarily correlated with clinical data in depressed patients

Sartorius, Alexander; Demirakça, Traute; Böhringer, Andreas; Hohenberg, Christian Clemm von; Aksay, Suna Su; Bumb, Jan Malte; Kranaster, Laura; Nickl‐Jockschat, Thomas; Grözinger, Michael; Thomann, Philipp A.; Wolf, Robert Christian; Zwanzger, Peter; Dannlowski, Udo; Redlich, Ronny; Zavorotnyy, Maxim; Zöllner, Rebecca; Methfessel, Isabel; Besse, Matthias; Zilles, David; Ende, Gabriele

doi:10.1016/j.brs.2018.11.017

Cited by 51 publications

(39 citation statements)

References 59 publications

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“…a direct comparison between remitted patients and non-remitted patients) may be meaningful. Although it is speculative, structural plasticity in the CA4/DG may not be the sufficient change, but the necessary change for clinical remission [33]. Another possibility for discrepancies includes a difference in the clinical characteristics of participants.…”

Section: Ect-induced Volume Increase and Agementioning

confidence: 99%

Acute and long-term effects of electroconvulsive therapy on human dentate gyrus

Takamiya

Plitman

Chung

et al. 2019

Neuropsychopharmacol.

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Electroconvulsive therapy (ECT) is the most effective treatment for severe depression, although the underlying mechanisms remain unclear. Animal studies have consistently shown that electroconvulsive stimulation induces neuroplastic changes in the dentate gyrus. To date, few studies have investigated the effect of ECT on human hippocampal subfields. In the current study, structural magnetic resonance imaging (MRI) was conducted in 25 patients with major depressive episodes at 3 time points: before ECT (TP1), after 1 week of the last ECT (TP2) and after 3 months of the last ECT (TP3). Twenty healthy controls were scanned twice with an interval similar to patients between TP1 and TP2. Volumetric analyses of the cornu ammonis (CA)4/dentate gyrus (DG) were performed using the MAGeT-Brain (Multiple Automatically Generated Templates) algorithm. Clinically remitted patients after ECT showed larger volume increases in the right CA4/DG than non-remitted patients. Volume increases in the right CA4/DG were negatively associated with age. Increased CA4/DG volumes after ECT returned to baseline levels after 3 months irrespective of clinical state. ECT-induced volume increase in the CA4/DG was associated with age and clinical remission. These findings are consistent with the neurotrophic processes seen in preclinical studies. Neuroplastic change in the CA4/DG might mediate some of the short-term antidepressant effects of ECT.

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Section: Ect-induced Volume Increase and Agementioning

confidence: 99%

Acute and long-term effects of electroconvulsive therapy on human dentate gyrus

Takamiya

Plitman

Chung

et al. 2019

Neuropsychopharmacol.

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“…However, some studies did establish a positive correlation between hippocampal volume change and clinical outcome 61,70,71 . Several other studies did not find this effect or identified even a negative correlation 7,69,72–75 . It is possible that hippocampal volume increase following ECT is related more to the electrical current or to the seizure aspect of the treatment, rather than to its therapeutic effects 7 .…”

Section: Discussionmentioning

confidence: 93%

Hippocampal volume change following ECT is mediated by rs699947 in the promotor region of VEGF

et al. 2019

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Several studies have shown that electroconvulsive therapy (ECT) results in increased hippocampal volume. It is likely that a multitude of mechanisms including neurogenesis, gliogenesis, synaptogenesis, angiogenesis, and vasculogenesis contribute to this volume increase. Neurotrophins, like vascular endothelial growth factor (VEGF) and brain-derived neurotrophic factor (BDNF) seem to play a crucial mediating role in several of these mechanisms. We hypothesized that two regulatory SNPs in the VEGF and BDNF gene influence the changes in hippocampal volume following ECT. We combined genotyping and brain MRI assessment in a sample of older adults suffering from major depressive disorder to test this hypothesis. Our results show an effect of rs699947 (in the promotor region of VEGF ) on hippocampal volume changes following ECT. However, we did not find a clear effect of rs6265 (in BDNF ). To the best of our knowledge, this is the first study investigating possible genetic mechanisms involved in hippocampal volume change during ECT treatment.

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“…In particular, the gray matter volumetric enlargements may not be predictive of a favorable outcome, though this was partially attributed to the heterogeneity among patients and the procedure and apparatus used (Ousdal et al, 2019). Moreover, a retrospective study revealed that though gray matter was enlarged, the changes may not correlate with psychopathology, age, gender, or number of ECT sessions (Sartorius et al, 2019), as did a longitudinal study of severe late-life unipolar depression (Bouckaert et al, 2016).…”

Section: Clinical Observation By Medical Imaging Programsmentioning

confidence: 99%

Effects of Electroconvulsive Therapy on Depression and Its Potential Mechanism

Yao

Sun

et al. 2020

Front. Psychol.

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Depression is one of the most common disorders causing mortality around the world. Although electroconvulsive therapy (ECT) is, along with antidepressants and psychotherapy, one of the three major treatments of depression, it is still considered as the last resort for depressed patients. This situation is partially due to limited studies and uncertainty regarding its mechanism. However, decades of increased research have focused on the effects of ECT on depression and its potential mechanism. Furthermore, these investigations may suggest that ECT should be a first-line therapy for depression due to its profound effects in relieving desperation in certain situations. Here, we outline recent clinical and preclinical studies and summarize the advantages and disadvantages of ECT. Thus, this review may provide some hints for clinical application.

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Electroconvulsive therapy induced gray matter increase is not necessarily correlated with clinical data in depressed patients

Cited by 51 publications

References 59 publications

Acute and long-term effects of electroconvulsive therapy on human dentate gyrus

Acute and long-term effects of electroconvulsive therapy on human dentate gyrus

Hippocampal volume change following ECT is mediated by rs699947 in the promotor region of VEGF

Effects of Electroconvulsive Therapy on Depression and Its Potential Mechanism

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