Volume of the human hippocampus and clinical response following electroconvulsive therapy

Research output: Contribution to journalJournal article – Annual report year: 2018Researchpeer-review

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  • Author: Oltedal, Leif

    University of Bergen, Norway

  • Author: Narr, Katherine L.

    University of California, United States

  • Author: Abbott, Christopher

    University of New Mexico, United States

  • Author: Anand, Amit

    Cleveland Clinic Ohio, United States

  • Author: Argyelan, Miklos

    Feinstein Institute for Medical Research, United States

  • Author: Bartsch, Hauke

    University of California, United States

  • Author: Dannlowski, Udo

    University of Münster, Germany

  • Author: Dols, Annemieke

    VU University Medical Centre, Netherlands

  • Author: van Eijndhoven, Philip

    Donders Institute for Brain, Cognition and Behavior, Netherlands

  • Author: Emsell, Louise

    University of Münster, Germany

  • Author: Erchinger, Vera Jane

    University of Bergen, Norway

  • Author: Espinoza, Randall

    University of California, United States

  • Author: Hahn, Tim

    University of Münster, Germany

  • Author: Hanson, Lars G.

    Center for Magnetic Resonance, Department of Electrical Engineering, Technical University of Denmark, Ørsteds Plads, 2800, Kgs. Lyngby, Denmark

  • Author: Hellemann, Gerhard

    University of Münster, United States

  • Author: Jorgensen, Martin Balslev

    Psychiatric Center Copenhagen, Rigshospitalet, Denmark

  • Author: Kessler, Ute

    University of Bergen, Norway

  • Author: Oudega, Mardien L.

    VU University Medical Centre, Netherlands

  • Author: Paulson, Olaf B.

    Copenhagen University Hospital, Denmark

  • Author: Redlich, Ronny

    University of Münster, Germany

  • Author: Sienaert, Pascal

    KU Leuven, Belgium

  • Author: Stek, Max L.

    VU University Medical Centre, Netherlands

  • Author: Tendolkar, Indira

    Donders Institute for Brain, Cognition and Behavior, Netherlands

  • Author: Vandenbulcke, Mathieu

    KU Leuven, Belgium

  • Author: Oedegaard, Ketil J.

    University of Bergen, Norway

  • Author: Dale, Anders M.

    University of California, United States

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Background: Hippocampal enlargements are commonly reported following electroconvulsive therapy (ECT). To clarify mechanisms, we examined if ECT induced hippocampal volume change relates to dose (number of ECT sessions and electrode placement) and acts as a biomarker of clinical outcome. Methods: Longitudinal neuroimaging and clinical data from ten independent sites participating in the Global ECT-MRI Research Collaboration were obtained for mega analysis. Hippocampal volumes were extracted from structural MR images, acquired before and after patients (n=281) experiencing a major depressive episode completed an ECT treatment series using right unilateral (RUL) and bilateral (BL) stimulation. Untreated non-depressed controls (n=95) were scanned twice. Results: The linear component of hippocampal volume change was 0.28%, 0.08 SE, per ECT session, p<0.001. Volume change varied by electrode placement in the left (BL: 3.3 ± 2.2%, d=1.5; RUL: 1.6 ± 2.1%, d=0.8; p<0.0001), but not the right hippocampus (BL: 3.0 ± 1.7%, d=1.8; RUL: 2.7 ± 2.0%, d=1.4; p=0.36,). Volume change for electrode placement per ECT session varied similarly by hemisphere. Individuals with greater treatment-related volume increases had poorer outcomes (MADRS change -1.0, 0.35 SE, per 1% volume increase, p=0.005), although effects were not significant after controlling for ECT number (slope: -0.69, 0.38 SE, p=0.069). Conclusions: The number of ECT sessions and electrode placement impacts the extent and laterality of hippocampal enlargement, but volume change is not positively associated with clinical outcome. Results suggest the high efficacy of ECT is not explained by hippocampal enlargement, which alone, might not serve as a viable biomarker for treatment outcome.
Original languageEnglish
JournalBiological Psychiatry
Volume84
Issue number8
Pages (from-to)574-581
Number of pages8
ISSN0006-3223
DOIs
Publication statusPublished - 2018
CitationsWeb of Science® Times Cited: No match on DOI

    Research areas

  • ECT, Brain, Depression, Neuroimaging, Antidepressant response, Biomarker

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