Pre-Treatment Amygdala Volume Predicts Electroconvulsive Therapy Response

Abbott

et al. 2017

Neuropsychopharmacol.

Owing to the rapid and robust clinical effects, electroconvulsive therapy (ECT) represents an optimal model to develop and test treatment predictors for major depressive disorders (MDDs), whereas imaging markers can be informative in identifying MDD patients who will respond to a specific antidepressant treatment or not. Here we aim to predict post-ECT depressive rating changes and remission status using pre-ECT gray matter (GM) in 38 MDD patients and validate in two independent data sets. Six GM regions including the right hippocampus/parahippocampus, right orbitofrontal gyrus, right inferior temporal gyrus (ITG), left postcentral gyrus/precuneus, left supplementary motor area, and left lingual gyrus were identified as predictors of ECT response, achieving accuracy of 89, 90 and 86% for remission prediction in three independent, age-matched data sets, respectively. For MDD patients, GM density increases only in the left supplementary motor cortex and left postcentral gyrus/precuneus after ECT. These results suggest that treatment-predictive and treatment-responsive regions may be anatomically different but functionally related in the context of ECT response. To the best of our knowledge, this is the first attempt to quantitatively identify and validate the ECT treatment biomarkers using multi-site GM data. We address a major clinical challenge and provide potential opportunities for more effective and timely interventions for electroconvulsive treatment.

Section: Introductionmentioning

confidence: 99%

SMRI Biomarkers Predict Electroconvulsive Treatment Outcomes: Accuracy with Independent Data Sets

Abbott

et al. 2017

Neuropsychopharmacol.

“…Another study has shown smaller hippocampal volumes in TRD patients relative to controls contrasting with our results that show no difference (Joshi et al., ). Interestingly, in this study, smaller hippocampal and larger amygdala volumes associated with response to subsequent ECT treatment, which further increased amygdala volume (Joshi et al., ; Ten Doesschate, van Eijndhoven, Tendolkar, van Wingen, & van Waarde, ). Thus, the question arises whether changes in amygdala volume in MDD are a trait characteristic of the disease or are related to disease progression, chronicity, or medication.…”

Section: Discussionmentioning

confidence: 50%

Amygdala and regional volumes in treatment-resistantversusnontreatment-resistant depression patients

et al. 2017

Int J Geriat Psychiatry

“…In addition, previous studies demonstrated that WMH, are important foci in patients suffering from apathy . These measures were therefore included in the MODECT‐study.…”

Section: Discussionmentioning

confidence: 99%

The course of apathy in late‐life depression treated with electroconvulsive therapy; a prospective cohort study

Carlier

Exel

Dols

et al. 2018

Objectives Apathy, a lack of motivation, is frequently seen in older individuals, with and without depression, with substantial impact on quality of life. This prospective cohort study of patients with severe late‐life depression treated with electroconvulsive therapy (ECT) aims to study the course of apathy and the predictive value of vascular burden and in particular white matter hyperintensities on apathy course. Methods Information on apathy (defined by a score of >13 on the Apathy Scale), depression severity, vascular burden, and other putative confounders was collected in at 2 psychiatric hospitals on patients with late‐life depression (aged 55 to 87 years, N = 73). MRI data on white matter hyperintensities were available in 52 patients. Possible risk factors for apathy post‐ECT were determined using regression analyses. Results After treatment with ECT, 52.0% (26/50) of the depression remitters still suffered from clinically relevant apathy symptoms. In the entire cohort, more patients remained apathetic (58.9%) than depressed (31.5%). Presence of apathy post‐ECT was not associated with higher age, use of benzodiazepines, or severity of apathy and depression at baseline. Less response in depressive symptomatology after ECT predicted post‐treatment apathy. The presence of vascular disease, diabetes mellitus and smoking, and white matter hyperintensities in the brain was not associated with post‐treatment apathy. Conclusions Apathy may perpetuate in individual patients, despite remission of depressive symptoms. In this cohort of patients with late‐life depression, post‐ECT apathy is not associated with white matter hyperintensities.