Elevated body weight modulates subcortical volume change and associated clinical response following electroconvulsive therapy

Abstract

Background: Obesity is a frequent somatic comorbidity of major depression, and it has been associated with worse clinical outcomes and brain structural abnormalities. Converging evidence suggests that electroconvulsive therapy (ECT) induces both clinical improvements and increased subcortical grey matter volume in patients with depression. However, it remains unknown whether increased body weight modulates the clinical response and structural neuroplasticity that occur with ECT. Methods: To address this question, we conducted a longitudinal investigation of structural MRI data from the Global ECT-MRI Research Collaboration (GEMRIC) in 223 patients who were experiencing a major depressive episode (10 scanning sites). Structural MRI data were acquired before and after ECT, and we assessed change in subcortical grey matter volume using FreeSurfer and Quarc. Results: Higher body mass index (BMI) was associated with a significantly lower increase in subcortical grey matter volume following ECT. We observed significant negative associations between BMI and change in subcortical grey matter volume, with pronounced effects in the thalamus and putamen, where obese participants showed increases in grey matter volume that were 43.3% and 49.6%, respectively, of the increases found in participants with normal weight. As well, BMI significantly moderated the association between subcortical grey matter volume change and clinical response to ECT. We observed no significant association between BMI and clinical response to ECT. Limitations: Because only baseline BMI values were available, we were unable to study BMI changes during ECT and their potential association with clinical and grey matter volume change. Conclusion: Future studies should take into account the relevance of body weight as a modulator of structural neuroplasticity during ECT treatment and aim to further explore the functional relevance of this novel finding.

Relating neighborhood deprivation to childhood obesity in the ABCD study: Evidence for theories of neuroinflammation and neuronal stress.

“…One interpretation could be that even though area deprivation is associated with smaller cortical volumes, among these youth, those who are heavier have larger subcortical volume of the ventral DC than those who are leaner. This theory would be consistent with the extant literature showing that BMI is related to larger subcortical volumes (Opel et al, 2021), but also that not all youth who live in deprived neighborhoods have overweight/obesity. Thus, this could be one reason to explain why area deprivation shows bidirectional effects of ventral DC volume within the context of BMI.…”

Microbiome First Medicine in Health and Safety

“…Obesity is one of the major conditions that gives rise to a myriad of comorbid, inflammation driven, chronic diseases particularly as aging progresses [ 62 , 63 ]. Table 2 illustrates examples of 43 comorbid NCDs for obesity [ 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 ]. The obese population carries one of the highest risks for multiple future NCDs of any disease-burdened cohort.…”

What Can We Tell About the Effect of Electroconvulsive Therapy on the Human Hippocampus?

“…In addition, this approach will enable an investigation of the underlying biology for each subtype of depression (eg, melancholic/psychotic/atypical depression). For instance, the relationship between clinical improvement and the left thalamic volume changes following ECT depended on the body mass index (BMI) 105 ; this result might reflect the proportion of patients with atypical depression who showed an increase in appetite in each BMI group, although we did not explore this possibility in the original paper.…”