Brain changes induced by Electroconvulsive Therapy are broadly distributed

Olga Therese Ousdal, Miklos Argyelan, Katherine L. Narr, Christopher Abbott, Benjamin Wade, Mathieu Vandenbulcke, Mikel Urretavizcaya, Indira Tendolkar, Akihiro Takamiya, Max L. Stek, Carles Soriano-Mas, Ronny Redlich, Olaf B. Paulson, Mardien L. Oudega, Nils Opel, Pia Nordanskog, Taishiro Kishimoto, Robin Kampe, Anders Jorgensen, Lars G. HansonJ. Paul Hamilton, Randall Espinoza, Louise Emsell, Philip van Eijndhoven, Annemieke Dols, Udo Dannlowski, Narcis Cardoner, Filip Bouckaert, Amit Anand, Hauke Bartsch, Ute Kessler, Ketil J. Oedegaard, Anders M. Dale, Leif Oltedal

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Abstract

Background Electroconvulsive therapy (ECT) is associated with volumetric enlargements of cortico-limbic brain regions. However, the pattern of whole-brain structural alterations following ECT remains unresolved. Here, we examined the longitudinal effects of ECT on global and local variations in gray matter, white matter and ventricle volumes in major depression as well as predictors of ECT-related clinical response. Methods Longitudinal MRI and clinical data from the Global ECT-MRI Research Collaboration (GEMRIC) were used to investigate changes in white matter, gray matter and ventricle volumes before and after ECT in 328 patients experiencing a major depressive episode. In addition, 95 non-depressed control subjects were scanned twice. We performed a mega-analysis of single subject data from 14 independent GEMRIC sites. Results Volumetric increases occurred in 79 of 84 gray matter regions of interests. In total, the cortical volume increased by (mean ± SD) 1.04 ± 1.03 % (Cohen's d=1.01, p<0.001)) and the subcortical gray matter volume increased by 1.47 ± 1.05 % (d=1.40, p<0.001) in patients. The subcortical gray matter increase was negatively associated with total ventricle volume (Spearman’s rank correlation rho=-0.44, p<0.001), while total white matter volume remained unchanged (d=-0.05, p=0.41). The changes were modulated by number of ECTs and mode of electrode placements. However, the gray matter volumetric enlargements were not associated with clinical outcome. Conclusions The findings suggest that ECT induces gray matter volumetric increases that are broadly distributed. However, gross volumetric increases of specific anatomically defined regions may not serve as feasible biomarkers of clinical response.
Original languageEnglish
JournalBiological Psychiatry
Number of pages32
ISSN0006-3223
DOIs
Publication statusAccepted/In press - 2019

Keywords

  • Depression
  • ECT
  • MRI
  • Neuroimaging
  • Antidepressant
  • Biomarker
  • Brain

Cite this

Ousdal, O. T., Argyelan, M., Narr, K. L., Abbott, C., Wade, B., Vandenbulcke, M., ... Oltedal, L. (Accepted/In press). Brain changes induced by Electroconvulsive Therapy are broadly distributed. Biological Psychiatry. https://doi.org/10.1016/j.biopsych.2019.07.010
Ousdal, Olga Therese ; Argyelan, Miklos ; Narr, Katherine L. ; Abbott, Christopher ; Wade, Benjamin ; Vandenbulcke, Mathieu ; Urretavizcaya, Mikel ; Tendolkar, Indira ; Takamiya, Akihiro ; Stek, Max L. ; Soriano-Mas, Carles ; Redlich, Ronny ; Paulson, Olaf B. ; Oudega, Mardien L. ; Opel, Nils ; Nordanskog, Pia ; Kishimoto, Taishiro ; Kampe, Robin ; Jorgensen, Anders ; Hanson, Lars G. ; Hamilton, J. Paul ; Espinoza, Randall ; Emsell, Louise ; van Eijndhoven, Philip ; Dols, Annemieke ; Dannlowski, Udo ; Cardoner, Narcis ; Bouckaert, Filip ; Anand, Amit ; Bartsch, Hauke ; Kessler, Ute ; Oedegaard, Ketil J. ; Dale, Anders M. ; Oltedal, Leif. / Brain changes induced by Electroconvulsive Therapy are broadly distributed. In: Biological Psychiatry. 2019.
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title = "Brain changes induced by Electroconvulsive Therapy are broadly distributed",
abstract = "Background Electroconvulsive therapy (ECT) is associated with volumetric enlargements of cortico-limbic brain regions. However, the pattern of whole-brain structural alterations following ECT remains unresolved. Here, we examined the longitudinal effects of ECT on global and local variations in gray matter, white matter and ventricle volumes in major depression as well as predictors of ECT-related clinical response. Methods Longitudinal MRI and clinical data from the Global ECT-MRI Research Collaboration (GEMRIC) were used to investigate changes in white matter, gray matter and ventricle volumes before and after ECT in 328 patients experiencing a major depressive episode. In addition, 95 non-depressed control subjects were scanned twice. We performed a mega-analysis of single subject data from 14 independent GEMRIC sites. Results Volumetric increases occurred in 79 of 84 gray matter regions of interests. In total, the cortical volume increased by (mean ± SD) 1.04 ± 1.03 {\%} (Cohen's d=1.01, p<0.001)) and the subcortical gray matter volume increased by 1.47 ± 1.05 {\%} (d=1.40, p<0.001) in patients. The subcortical gray matter increase was negatively associated with total ventricle volume (Spearman’s rank correlation rho=-0.44, p<0.001), while total white matter volume remained unchanged (d=-0.05, p=0.41). The changes were modulated by number of ECTs and mode of electrode placements. However, the gray matter volumetric enlargements were not associated with clinical outcome. Conclusions The findings suggest that ECT induces gray matter volumetric increases that are broadly distributed. However, gross volumetric increases of specific anatomically defined regions may not serve as feasible biomarkers of clinical response.",
keywords = "Depression, ECT, MRI, Neuroimaging, Antidepressant, Biomarker, Brain",
author = "Ousdal, {Olga Therese} and Miklos Argyelan and Narr, {Katherine L.} and Christopher Abbott and Benjamin Wade and Mathieu Vandenbulcke and Mikel Urretavizcaya and Indira Tendolkar and Akihiro Takamiya and Stek, {Max L.} and Carles Soriano-Mas and Ronny Redlich and Paulson, {Olaf B.} and Oudega, {Mardien L.} and Nils Opel and Pia Nordanskog and Taishiro Kishimoto and Robin Kampe and Anders Jorgensen and Hanson, {Lars G.} and Hamilton, {J. Paul} and Randall Espinoza and Louise Emsell and {van Eijndhoven}, Philip and Annemieke Dols and Udo Dannlowski and Narcis Cardoner and Filip Bouckaert and Amit Anand and Hauke Bartsch and Ute Kessler and Oedegaard, {Ketil J.} and Dale, {Anders M.} and Leif Oltedal",
year = "2019",
doi = "10.1016/j.biopsych.2019.07.010",
language = "English",
journal = "Biological Psychiatry",
issn = "0006-3223",
publisher = "Elsevier",

}

Ousdal, OT, Argyelan, M, Narr, KL, Abbott, C, Wade, B, Vandenbulcke, M, Urretavizcaya, M, Tendolkar, I, Takamiya, A, Stek, ML, Soriano-Mas, C, Redlich, R, Paulson, OB, Oudega, ML, Opel, N, Nordanskog, P, Kishimoto, T, Kampe, R, Jorgensen, A, Hanson, LG, Hamilton, JP, Espinoza, R, Emsell, L, van Eijndhoven, P, Dols, A, Dannlowski, U, Cardoner, N, Bouckaert, F, Anand, A, Bartsch, H, Kessler, U, Oedegaard, KJ, Dale, AM & Oltedal, L 2019, 'Brain changes induced by Electroconvulsive Therapy are broadly distributed', Biological Psychiatry. https://doi.org/10.1016/j.biopsych.2019.07.010

Brain changes induced by Electroconvulsive Therapy are broadly distributed. / Ousdal, Olga Therese; Argyelan, Miklos; Narr, Katherine L.; Abbott, Christopher; Wade, Benjamin; Vandenbulcke, Mathieu; Urretavizcaya, Mikel; Tendolkar, Indira; Takamiya, Akihiro; Stek, Max L.; Soriano-Mas, Carles; Redlich, Ronny; Paulson, Olaf B.; Oudega, Mardien L.; Opel, Nils; Nordanskog, Pia; Kishimoto, Taishiro; Kampe, Robin; Jorgensen, Anders; Hanson, Lars G. ; Hamilton, J. Paul; Espinoza, Randall; Emsell, Louise; van Eijndhoven, Philip; Dols, Annemieke; Dannlowski, Udo; Cardoner, Narcis; Bouckaert, Filip; Anand, Amit; Bartsch, Hauke; Kessler, Ute; Oedegaard, Ketil J.; Dale, Anders M.; Oltedal, Leif.

In: Biological Psychiatry, 2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Brain changes induced by Electroconvulsive Therapy are broadly distributed

AU - Ousdal, Olga Therese

AU - Argyelan, Miklos

AU - Narr, Katherine L.

AU - Abbott, Christopher

AU - Wade, Benjamin

AU - Vandenbulcke, Mathieu

AU - Urretavizcaya, Mikel

AU - Tendolkar, Indira

AU - Takamiya, Akihiro

AU - Stek, Max L.

AU - Soriano-Mas, Carles

AU - Redlich, Ronny

AU - Paulson, Olaf B.

AU - Oudega, Mardien L.

AU - Opel, Nils

AU - Nordanskog, Pia

AU - Kishimoto, Taishiro

AU - Kampe, Robin

AU - Jorgensen, Anders

AU - Hanson, Lars G.

AU - Hamilton, J. Paul

AU - Espinoza, Randall

AU - Emsell, Louise

AU - van Eijndhoven, Philip

AU - Dols, Annemieke

AU - Dannlowski, Udo

AU - Cardoner, Narcis

AU - Bouckaert, Filip

AU - Anand, Amit

AU - Bartsch, Hauke

AU - Kessler, Ute

AU - Oedegaard, Ketil J.

AU - Dale, Anders M.

AU - Oltedal, Leif

PY - 2019

Y1 - 2019

N2 - Background Electroconvulsive therapy (ECT) is associated with volumetric enlargements of cortico-limbic brain regions. However, the pattern of whole-brain structural alterations following ECT remains unresolved. Here, we examined the longitudinal effects of ECT on global and local variations in gray matter, white matter and ventricle volumes in major depression as well as predictors of ECT-related clinical response. Methods Longitudinal MRI and clinical data from the Global ECT-MRI Research Collaboration (GEMRIC) were used to investigate changes in white matter, gray matter and ventricle volumes before and after ECT in 328 patients experiencing a major depressive episode. In addition, 95 non-depressed control subjects were scanned twice. We performed a mega-analysis of single subject data from 14 independent GEMRIC sites. Results Volumetric increases occurred in 79 of 84 gray matter regions of interests. In total, the cortical volume increased by (mean ± SD) 1.04 ± 1.03 % (Cohen's d=1.01, p<0.001)) and the subcortical gray matter volume increased by 1.47 ± 1.05 % (d=1.40, p<0.001) in patients. The subcortical gray matter increase was negatively associated with total ventricle volume (Spearman’s rank correlation rho=-0.44, p<0.001), while total white matter volume remained unchanged (d=-0.05, p=0.41). The changes were modulated by number of ECTs and mode of electrode placements. However, the gray matter volumetric enlargements were not associated with clinical outcome. Conclusions The findings suggest that ECT induces gray matter volumetric increases that are broadly distributed. However, gross volumetric increases of specific anatomically defined regions may not serve as feasible biomarkers of clinical response.

AB - Background Electroconvulsive therapy (ECT) is associated with volumetric enlargements of cortico-limbic brain regions. However, the pattern of whole-brain structural alterations following ECT remains unresolved. Here, we examined the longitudinal effects of ECT on global and local variations in gray matter, white matter and ventricle volumes in major depression as well as predictors of ECT-related clinical response. Methods Longitudinal MRI and clinical data from the Global ECT-MRI Research Collaboration (GEMRIC) were used to investigate changes in white matter, gray matter and ventricle volumes before and after ECT in 328 patients experiencing a major depressive episode. In addition, 95 non-depressed control subjects were scanned twice. We performed a mega-analysis of single subject data from 14 independent GEMRIC sites. Results Volumetric increases occurred in 79 of 84 gray matter regions of interests. In total, the cortical volume increased by (mean ± SD) 1.04 ± 1.03 % (Cohen's d=1.01, p<0.001)) and the subcortical gray matter volume increased by 1.47 ± 1.05 % (d=1.40, p<0.001) in patients. The subcortical gray matter increase was negatively associated with total ventricle volume (Spearman’s rank correlation rho=-0.44, p<0.001), while total white matter volume remained unchanged (d=-0.05, p=0.41). The changes were modulated by number of ECTs and mode of electrode placements. However, the gray matter volumetric enlargements were not associated with clinical outcome. Conclusions The findings suggest that ECT induces gray matter volumetric increases that are broadly distributed. However, gross volumetric increases of specific anatomically defined regions may not serve as feasible biomarkers of clinical response.

KW - Depression

KW - ECT

KW - MRI

KW - Neuroimaging

KW - Antidepressant

KW - Biomarker

KW - Brain

U2 - 10.1016/j.biopsych.2019.07.010

DO - 10.1016/j.biopsych.2019.07.010

M3 - Journal article

C2 - 31561859

JO - Biological Psychiatry

JF - Biological Psychiatry

SN - 0006-3223

ER -