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Clinical Trial
. 2020 Mar 10;23(1):20-25.
doi: 10.1093/ijnp/pyz059.

Changes in White Matter Microstructure After Electroconvulsive Therapy for Treatment-Resistant Depression

Gregor Gryglewski  1 , René Seiger  1 , Pia Baldinger-Melich  1 , Jakob Unterholzner  1 , Benjamin Spurny  1 , Thomas Vanicek  1 , Andreas Hahn  1 , Siegfried Kasper  1 , Richard Frey  1 , Rupert Lanzenberger  1
Affiliations
Clinical Trial

Changes in White Matter Microstructure After Electroconvulsive Therapy for Treatment-Resistant Depression

Gregor Gryglewski et al. Int J Neuropsychopharmacol. .

Abstract

Background: Treatment-resistant depression is among the most debilitating conditions in psychiatry. Recent studies have associated alterations in white matter microstructure measured with magnetic resonance imaging with poor antidepressant response. Therefore, the extent to which electroconvulsive therapy, the most effective therapeutic option for treatment-resistant depression, affects white matter microstructure warrants investigation.

Methods: A total 13 patients suffering from severe unipolar treatment-resistant depression underwent magnetic resonance imaging with a diffusion tensor imaging sequence before and after undergoing a series of right unilateral electroconvulsive therapy. Diffusivity metrics were compared voxel-wise using tract-based spatial statistics and repeated-measures ANOVA.

Results: A total 12 patients responded to electroconvulsive therapy and 9 were classified as remitters. An increase in axial diffusivity was observed in the posterior limb of the internal capsule of the right hemisphere (PFWE ≤ .05). The increase in this area was higher in the right compared with the left hemisphere (P < .05). No correlation of this effect with treatment response could be found.

Conclusions: The strong lateralization of effects to the hemisphere of electrical stimulation suggests an effect of electroconvulsive therapy on diffusivity metrics which is dependent of electrode placement. Investigation in controlled studies is necessary to reveal to what extent the effects of electroconvulsive therapy on white matter microstructure are related to clinical outcomes and electrode placement.

Keywords: diffusion weighted imaging; electroconvulsive therapy; magnetic resonance imaging; treatment-resistant depression.

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Figures

Figure 1.
Figure 1.
Significant changes in axial diffusivity after electroconvulsive therapy (ECT). A cluster with increased axial diffusivity is overlaid on the mean fractional anisotropy (FA) skeleton and a T1 weighted standard brain (P family wise error [PFWE] < .05, MNI-coordinates (xyz): 11|-4|2).
See this image and copyright information in PMC

References

    1. Andersson JLR, Sotiropoulos SN (2016) An integrated approach to correction for off-resonance effects and subject movement in diffusion MR imaging. Neuroimage 125:1063–1078. - PMC - PubMed
    1. Andersson JLR, Graham MS, Zsoldos E, Sotiropoulos SN (2016) Incorporating outlier detection and replacement into a non-parametric framework for movement and distortion correction of diffusion MR images. Neuroimage 141:556–572. - PubMed
    1. Andrade C, Bolwig TG (2014) Electroconvulsive therapy, hypertensive surge, blood-brain barrier breach, and amnesia: exploring the evidence for a connection. J ECT 30:160–164. - PubMed
    1. Bai T, Wei Q, Xie W, Wang A, Wang J, Ji GJ, Wang K, Tian Y (2019) Hippocampal-subregion functional alterations associated with antidepressant effects and cognitive impairments of electroconvulsive therapy. Psychol Med 49:1357–1364. - PMC - PubMed
    1. Bauer M, Severus E, Köhler S, Whybrow PC, Angst J, Möller HJ; Wfsbp Task Force on Treatment Guidelines for Unipolar Depressive Disorders (2015) World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders. part 2: maintenance treatment of major depressive disorder-update 2015. World J Biol Psychiatry 16:76–95. - PubMed

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