Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-13T09:22:25.744Z Has data issue: false hasContentIssue false
  • English
  • Français

Structural–functional brain changes in depressed patients during and after electroconvulsive therapy

Published online by Cambridge University Press:  23 November 2016

Antoine Yrondi ,
Patrice Péran ,
Anne Sauvaget ,
Laurent Schmitt  and
Christophe Arbus
Antoine Yrondi*
Affiliation:
Psychiatric Department, CHU Toulouse-Purpan, Toulouse, France Toulouse NeuroImaging Center, ToNIC, University of Toulouse, Inserm, UPS, France
Patrice Péran
Affiliation:
Toulouse NeuroImaging Center, ToNIC, University of Toulouse, Inserm, UPS, France
Anne Sauvaget
Affiliation:
Addictology and Liaison Psychiatry Department, CHU Nantes, ‘Neuromodulation Unit in Psychiatry’, Nantes, France EA 4275 SPHERE ‘Methods for Patients-Centered Outcomes & Health Research’, Faculty of Pharmaceutical Sciences, Université Nantes, Nantes, France
Laurent Schmitt
Affiliation:
Psychiatric Department, CHU Toulouse-Purpan, Toulouse, France
Christophe Arbus
Affiliation:
Psychiatric Department, CHU Toulouse-Purpan, Toulouse, France Toulouse NeuroImaging Center, ToNIC, University of Toulouse, Inserm, UPS, France
*
Dr. Antoine Yrondi, Service de psychiatrie et psychologie médicale, CHU Toulouse-Purpan, 330 avenue de Grande Bretagne, 31059 Toulouse, France. Tel: +33 5 34 55 75 37; Fax: +33 5 34 55 75 32; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

Electroconvulsive therapy (ECT) is a non-pharmacological treatment that is effective in treating severe and treatment-resistant depression. Although the efficacy of ECT has been demonstrated to treat major depressive disorder (MDD), the brain mechanisms underlying this process remain unclear. Structural–functional changes occur with the use of ECT as a treatment for depression based on magnetic resonance imaging (MRI). For this reason, we have tried to identify the changes that were identified by MRI to try to clarify some operating mechanisms of ECT. We focus to brain changes on MRI [structural MRI (sMRI), functional MRI (fMRI) and diffusion tensor imging (DTI)] after ECT.

Methods

A systematic search of the international literature was performed using the bibliographic search engines PubMed and Embase. The research focused on papers published up to 30 September 2015. The following Medical Subject Headings (MESH) terms were used: electroconvulsive therapy AND (MRI OR fMRI OR DTI). Papers published in English were included. Four authors searched the database using a predefined strategy to identify potentially eligible studies.

Results

There were structural changes according to the sMRI performed before and after ECT treatment. These changes do not seem to be entirely due to oedema. This investigation assessed the functional network connectivity associated with the ECT response in MDD. ECT response reverses the relationship from negative to positive between the two pairs of networks.

Conclusion

We found structural–functional changes in MRI post-ECT. Because of the currently limited MRI data on ECT in the literature, it is necessary to conduct further investigations using other MRI technology.

Keywords

depressiondepressive disorderelectroconvulsive therapymagnetic resonance imaging
Type
Review Articles
Information
Acta Neuropsychiatrica , Volume 30 , Issue 1 , February 2018 , pp. 17 - 28
Check for updates
Copyright
© Scandinavian College of Neuropsychopharmacology 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. ANAES. Indications et modalités de l’électroconvulsivothérapie. Fédération Française de Psychiatrie, Société Française d’Anesthésie et de Réanimation, Agence Nationale d’Accréditation et d’Evaluation en Santé (ANAES); 1998.Google Scholar
2. Baghai, TC, Möller, H-J. Electroconvulsive therapy and its different indications. Dialogues Clin Neurosci 2008;10:105–117.CrossRefGoogle ScholarPubMed
3. UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 2003;361:799–808.Google Scholar
4. Loo, C. ECT in the 21st century: optimizing treatment: state of the art in the 21st century. J ECT 2010;26:157.Google Scholar
5. Pagnin, D, de Queiroz, V, Pini, S, Cassano, GB. Efficacy of ECT in depression: a meta-analytic review. J ECT 2004;20:13–20.Google Scholar
6. Gangadhar, BN, Janakiramaiah, N, Subbakrishna, DK, Praveen, J, Reddy, AK. Twice versus thrice weekly ECT in melancholia: a double-blind prospective comparison. J Affect Disord 1993;27:273–278.CrossRefGoogle ScholarPubMed
7. Janakiramaiah, N, Motreja, S, Gangadhar, BN, Subbakrishna, DK, Parameshwara, G. Once vs. three times weekly ECT in melancholia: a randomized controlled trial. Acta Psychiatr Scand 1998;98:316–320.CrossRefGoogle ScholarPubMed
8. Lerer, B, Shapira, B, Calev, A et al. Antidepressant and cognitive effects of twice- versus three-times-weekly ECT. Am J Psychiatry 1995;152:564–570.Google ScholarPubMed
9. Taylor, S. Electroconvulsive therapy: a review of history, patient selection, technique, and medication management. South Med J 2007;100:494–498.Google Scholar
10. Svensson, M, Hallin, T, Broms, J, Ekstrand, J, Tingström, A. Spatial memory impairment in Morris water maze after electroconvulsive seizures. Acta Neuropsychiatr 2016;6231-10. DOI: https://doi.org/10.1017/neu.2016.22.Google Scholar
11. Siskind, D, Charlson, F, Saraf, S, Scheurer, R, Lie, DC. Twice versus thrice weekly ECT in a clinical population: an evaluation of patient outcomes. Psychiatry Res 2012;199:208–211.Google Scholar
12. Charlson, F, Siskind, D, Doi, SAR, McCallum, E, Broome, A, Lie, DC. ECT efficacy and treatment course: a systematic review and meta-analysis of twice vs thrice weekly schedules. J Affect Disord 2012;138:1–8.CrossRefGoogle ScholarPubMed
13. Husain, SS, Kevan, IM, Linnell, R, Scott, AIF. Electroconvulsive therapy in depressive illness that has not responded to drug treatment. J Affect Disord 2004;83:121–126.Google Scholar
14. Hoy, KE, Fitzgerald, PB. Brain stimulation in psychiatry and its effects on cognition. Nat Rev Neurol 2010;6:267–275.Google Scholar
15. Rudorfer, M, Henry, M, Sackeim, H. Electroconvulsive therapy. In: Tasman A, Kay J, Lieberman JA editors Psychiatry Therapeutics. Chichester: John Wiley & Sons, 2003.Google Scholar
16. Saijo, T, Takano, A, Suhara, T et al. Electroconvulsive therapy decreases dopamine D2 receptor binding in the anterior cingulate in patients with depression: a controlled study using positron emission tomography with radioligand [11C]FLB 457. J Clin Psychiatry 2010;71:793–799.Google Scholar
17. Saijo, T, Takano, A, Suhara, T et al. Effect of electroconvulsive therapy on 5-HT1A receptor binding in patients with depression: a PET study with [11C]WAY 100635. Int J Neuropsychopharmacol 2010;13:785–791.Google Scholar
18. Lanzenberger, R, Baldinger, P, Hahn, A et al. Global decrease of serotonin-1A receptor binding after electroconvulsive therapy in major depression measured by PET. Mol Psychiatry 2013;18:93–100.Google Scholar
19. Sackeim, HA. The anticonvulsant hypothesis of the mechanisms of action of ECT: current status. J ECT 1999;15:5–26.Google Scholar
20. Chen, F, Madsen, TM, Wegener, G, Nyengaard, JR. Repeated electroconvulsive seizures increase the total number of synapses in adult male rat hippocampus. Eur Neuropsychopharmacol 2009;19:329–338.CrossRefGoogle ScholarPubMed
21. Madsen, TM, Treschow, A, Bengzon, J, Bolwig, TG, Lindvall, O, Tingström, A. Increased neurogenesis in a model of electroconvulsive therapy. Biol Psychiatry 2000;47:1043–1049.CrossRefGoogle Scholar
22. Scott, BW, Wojtowicz, JM, Burnham, WM. Neurogenesis in the dentate gyrus of the rat following electroconvulsive shock seizures. Exp Neurol 2000;165:231–236.CrossRefGoogle ScholarPubMed
23. Wennström, M, Hellsten, J, Tingström, A. Electroconvulsive seizures induce proliferation of NG2-expressing glial cells in adult rat amygdala. Biol Psychiatry 2004;55:464–471.Google Scholar
24. Lekwauwa, RE, McQuoid, DR, Steffens, DC. Hippocampal volume as a predictor of short-term ECT outcomes in older patients with depression. Am J Geriatr Psychiatry 2005;13:910–913.Google Scholar
25. Lekwauwa, R, McQuoid, D, Steffens, DC. Hippocampal volume is associated with physician-reported acute cognitive deficits after electroconvulsive therapy. J Geriatr Psychiatry Neurol 2006;19:21–25.Google Scholar
26. Nordanskog, P, Dahlstrand, U, Larsson, MR, Larsson, E-M, Knutsson, L, Johanson, A. Increase in hippocampal volume after electroconvulsive therapy in patients with depression: a volumetric magnetic resonance imaging study. J ECT 2010;26:62–67.CrossRefGoogle ScholarPubMed
27. Blumberg, HP, Kaufman, J, Martin, A et al. Amygdala and hippocampal volumes in adolescents and adults with bipolar disorder. Arch Gen Psychiatry 2003;60:1201–1208.Google Scholar
28. Stone, VE, Baron-Cohen, S, Calder, A, Keane, J, Young, A. Acquired theory of mind impairments in individuals with bilateral amygdala lesions. Neuropsychologia 2003;41:209–220.Google Scholar
29. Koenigs, M, Grafman, J. The functional neuroanatomy of depression: distinct roles for ventromedial and dorsolateral prefrontal cortex. Behav Brain Res 2009;201:239–243.Google Scholar
30. Mayberg, HS. Modulating dysfunctional limbic-cortical circuits in depression: towards development of brain-based algorithms for diagnosis and optimised treatment. Br Med Bull 2003;65:193–207.Google Scholar
31. Phillips, ML, Ladouceur, CD, Drevets, WC. A neural model of voluntary and automatic emotion regulation: implications for understanding the pathophysiology and neurodevelopment of bipolar disorder. Mol Psychiatry 2008;13:829 833–857.CrossRefGoogle ScholarPubMed
32. Bertolino, A, Arciero, G, Rubino, V et al. Variation of human amygdala response during threatening stimuli as a function of 5’HTTLPR genotype and personality style. Biol Psychiatry 2005;57:1517–1525.Google Scholar
33. Hariri, AR, Drabant, EM, Munoz, KE et al. A susceptibility gene for affective disorders and the response of the human amygdala. Arch Gen Psychiatry 2005;62:146–152.Google Scholar
34. Heinz, A, Smolka, MN, Braus, DF et al. Serotonin transporter genotype (5-HTTLPR): effects of neutral and undefined conditions on amygdala activation. Biol Psychiatry 2007;61:1011–1014.CrossRefGoogle ScholarPubMed
35. Schultz, W. Behavioral dopamine signals. Trends Neurosci 2007;30:203–210.Google Scholar
36. Dannlowski, U, Ohrmann, P, Bauer, J et al. Amygdala reactivity to masked negative faces is associated with automatic judgmental bias in major depression: a 3 T fMRI study. J Psychiatry Neurosci JPN 2007;32:423–429.Google ScholarPubMed
37. Fales, CL, Barch, DM, Rundle, MM et al. Altered emotional interference processing in affective and cognitive-control brain circuitry in major depression. Biol Psychiatry 2008;63:377–384.CrossRefGoogle ScholarPubMed
38. Fu, CHY, Mourao-Miranda, J, Costafreda, SG et al. Pattern classification of sad facial processing: toward the development of neurobiological markers in depression. Biol Psychiatry 2008;63:656–662.CrossRefGoogle ScholarPubMed
39. Keedwell, PA, Andrew, C, Williams, SCR, Brammer, MJ, Phillips, ML. A double dissociation of ventromedial prefrontal cortical responses to sad and happy stimuli in depressed and healthy individuals. Biol Psychiatry 2005;58:495–503.Google Scholar
40. Surguladze, S, Brammer, MJ, Keedwell, P et al. A differential pattern of neural response toward sad versus happy facial expressions in major depressive disorder. Biol Psychiatry 2005;57:201–209.Google Scholar
41. Fitzgerald, PB, Laird, AR, Maller, J, Daskalakis, ZJ. A meta-analytic study of changes in brain activation in depression. Hum Brain Mapp 2008;29:683–695.Google Scholar
42. Zhuo, C, Yu, C. Functional neuroimaging changes subsequent to electroconvulsive therapy in unipolar depression: a review of the literature. J ECT 2014;30:265–274.Google Scholar
43. Bolwig, TG. Neuroimaging and electroconvulsive therapy: a review. J ECT 2014;30:138–142.Google Scholar
44. Abbott, CC, Gallegos, P, Rediske, N, Lemke, NT, Quinn, DK. A review of longitudinal electroconvulsive therapy: neuroimaging investigations. J Geriatr Psychiatry Neurol 2014;27:33–46.Google Scholar
45. Moher, D, Liberati, A, Tetzlaff, J, Altman, DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097.Google Scholar
46. Joshi, SH, Espinoza, RT, Pirnia, T et al. Structural plasticity of the hippocampus and amygdala induced by electroconvulsive therapy in major depression. Biol Psychiatry 2015; March 5.Google ScholarPubMed
47. Ota, M, Noda, T, Sato, N et al. Effect of electroconvulsive therapy on gray matter volume in major depressive disorder. J Affect Disord 2015;186:186–191.CrossRefGoogle ScholarPubMed
48. Bouckaert, F, De Winter, F-L, Emsell, L et al. Grey matter volume increase following electroconvulsive therapy in patients with late life depression: a longitudinal MRI study. J Psychiatry Neurosci JPN 2015;40:140322.Google Scholar
49. Dukart, J, Regen, F, Kherif, F et al. Electroconvulsive therapy-induced brain plasticity determines therapeutic outcome in mood disorders. Proc Natl Acad Sci U S A 2014;111:1156–1161.CrossRefGoogle ScholarPubMed
50. Abbott, CC, Jones, T, Lemke, NT et al. Hippocampal structural and functional changes associated with electroconvulsive therapy response. Transl Psychiatry 2014;4:e483.Google Scholar
51. Tendolkar, I, van Beek, M, van Oostrom, I et al. Electroconvulsive therapy increases hippocampal and amygdala volume in therapy refractory depression: a longitudinal pilot study. Psychiatry Res 2013;214:197–203.Google Scholar
52. Nordanskog, P, Larsson, MR, Larsson, E-M, Johanson, A. Hippocampal volume in relation to clinical and cognitive outcome after electroconvulsive therapy in depression. Acta Psychiatr Scand 2014;129:303–311.Google Scholar
53. Kunigiri, G, Jayakumar, PN, Janakiramaiah, N, Gangadhar, BN. MRI T(2) relaxometry of brain regions and cognitive dysfunction following electroconvulsive therapy. Indian J Psychiatry 2007;49:195–199.CrossRefGoogle ScholarPubMed
54. Szabo, K, Hirsch, JG, Krause, M et al. Diffusion weighted MRI in the early phase after electroconvulsive therapy. Neurol Res 2007;29:256–259.Google Scholar
55. Girish, K, Jayakumar, PN, Murali, N, Gangadhar, BN, Janakiramaiah, N, Subbakrishna, DK. Ect and t(2) relaxometry: a static walter proton magnetic resonance imaging study. Indian J Psychiatry 2001;43:22–24.Google Scholar
56. Diehl, DJ, Keshavan, MS, Kanal, E, Nebes, RD, Nichols, TE, Gillen, JS. Post-ECT increases in MRI regional T2 relaxation times and their relationship to cognitive side effects: a pilot study. Psychiatry Res 1994;54:177–184.Google Scholar
57. Coffey, CE, Figiel, GS, Djang, WT, Cress, M, Saunders, WB, Weiner, RD. Leukoencephalopathy in elderly depressed patients referred for ECT. Biol Psychiatry 1988;24:143–161.CrossRefGoogle ScholarPubMed
58. Scott, AI, Douglas, RH, Whitfield, A, Kendell, RE. Time course of cerebra; magnetic resonance changes after electroconvulsive therapy. Br J Psychiatry J Ment Sci 1990;156:551–553.Google Scholar
59. Oudega, ML, van Exel, E, Stek, ML et al. The structure of the geriatric depressed brain and response to electroconvulsive therapy. Psychiatry Res 2014;222:1–9.Google Scholar
60. Oudega, ML, Dols, A, Adelerhof, I et al. Contribution of white matter hyperintensities, medial temporal lobe atrophy and cortical atrophy on outcome, seven to twelve years after ECT in severely depressed geriatric patients. J Affect Disord 2015;185:144–148.Google Scholar
61. Oudega, ML, van Exel, E, Wattjes, MP et al. White matter hyperintensities and cognitive impairment during electroconvulsive therapy in severely depressed elderly patients. Am J Geriatr Psychiatry 2014;22:157–166.CrossRefGoogle ScholarPubMed
62. Abbott, CC, Lemke, NT, Gopal, S et al. Electroconvulsive therapy response in major depressive disorder: a pilot functional network connectivity resting state FMRI investigation. Front Psychiatry 2013;4:10.CrossRefGoogle ScholarPubMed
63. Wei, Q, Tian, Y, Yu, Y et al. Modulation of interhemispheric functional coordination in electroconvulsive therapy for depression. Transl Psychiatry 2014;4:e453.CrossRefGoogle ScholarPubMed
64. Perrin, JS, Merz, S, Bennett, DM et al. Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder. Proc Natl Acad Sci U S A 2012;109:5464–5468.Google Scholar
65. Beall, EB, Malone, DA, Dale, RM et al. Effects of electroconvulsive therapy on brain functional activation and connectivity in depression. J ECT 2012;28:234–241.CrossRefGoogle ScholarPubMed
66. Christ, M, Michael, N, Hihn, H et al. Auditory processing of sine tones before, during and after ECT in depressed patients by fMRI. J Neural Transm (Vienna) 2008;115:1199–1211.Google Scholar
67. Lyden, H, Espinoza, RT, Pirnia, T et al. Electroconvulsive therapy mediates neuroplasticity of white matter microstructure in major depression. Transl Psychiatry 2014;4:e380.Google Scholar
68. Jorgensen, A, Magnusson, P, Hanson, LG et al. Regional brain volumes, diffusivity, and metabolite changes after electroconvulsive therapy for severe depression. Acta Psychiatr Scand 2016;133:154–164.CrossRefGoogle Scholar
69. Peng, W, Chen, Z, Yin, L, Jia, Z, Gong, Q. Essential brain structural alterations in major depressive disorder: A voxel-wise meta-analysis on first episode, medication-naive patients. J Affect Disord 2016;199:114–123.Google Scholar
70. Fu, CHY, Costafreda, SG, Sankar, A et al. Multimodal functional and structural neuroimaging investigation of major depressive disorder following treatment with duloxetine. BMC Psychiatry 2015;15:82.Google Scholar
71. Kozel, FA, Johnson, KA, Nahas, Z et al. Fractional anisotropy changes after several weeks of daily left high-frequency repetitive transcranial magnetic stimulation of the prefrontal cortex to treat major depression. J ECT 2011;27:5–10.Google Scholar
72. Peterchev, AV, Rosa, MA, Deng, Z-D, Prudic, J, Lisanby, SH. Electroconvulsive therapy stimulus parameters: rethinking dosage. J ECT 2010;26:159–174.Google Scholar
73. Sackeim, HA, Prudic, J, Fuller, R, Keilp, J, Lavori, PW, Olfson, M. The cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacology 2007;32:244–254.Google Scholar
74. Sackeim, HA, Prudic, J, Nobler, MS et al. Effects of pulse width and electrode placement on the efficacy and cognitive effects of electroconvulsive therapy. Brain Stimul 2008;1:71–83.Google Scholar
75. Sackeim, HA, Prudic, J, Devanand, DP et al. Effects of stimulus intensity and electrode placement on the efficacy and cognitive effects of electroconvulsive therapy. N Engl J Med 1993;328:839–846.Google Scholar
76. Sackeim, HA, Prudic, J, Devanand, DP et al. A prospective, randomized, double-blind comparison of bilateral and right unilateral electroconvulsive therapy at different stimulus intensities. Arch Gen Psychiatry 2000;57:425–434.Google Scholar
77. Sackeim, HA. Convulsant and anticonvulsant properties of electroconvulsive therapy: towards a focal form of brain stimulation. Clin Neurosci Res 2004;4:39–57.Google Scholar
78. Sackeim, HA, Decina, P, Portnoy, S, Neeley, P, Malitz, S. Studies of dosage, seizure threshold, and seizure duration in ECT. Biol Psychiatry 1987;22:249–268.Google Scholar
79. Spellman, T, Peterchev, AV, Lisanby, SH. Focal electrically administered seizure therapy: a novel form of ECT illustrates the roles of current directionality, polarity, and electrode configuration in seizure induction. Neuropsychopharmacology 2009;34:2002–2010.Google Scholar
80. Nahas, Z, Short, B, Burns, C et al. A feasibility study of a new method for electrically producing seizures in man: focal electrically administered seizure therapy [FEAST]. Brain Stimul 2013;6:403–408.CrossRefGoogle ScholarPubMed
81. Chahine, G, Short, B, Spicer, K et al. Regional cerebral blood flow changes associated with focal electrically administered seizure therapy (FEAST). Brain Stimul 2014;7:483–485.Google Scholar
82. Péran, P, Cherubini, A, Assogna, F et al. Magnetic resonance imaging markers of Parkinson’s disease nigrostriatal signature.. Brain 2010;133:3423–3433.CrossRefGoogle ScholarPubMed
83. Péran, P, Cherubini, A, Luccichenti, G et al. Volume and iron content in basal ganglia and thalamus. Hum Brain Mapp 2009;30:2667–2675.Google Scholar
84. Péran, P, Hagberg, G, Luccichenti, G et al. Voxel-based analysis of R2* maps in the healthy human brain. J Magn Reson Imaging 2007;26:1413–1420.Google Scholar
85. Cherubini, A, Péran, P, Caltagirone, C, Sabatini, U, Spalletta, G. Aging of subcortical nuclei: microstructural, mineralization and atrophy modifications measured in vivo using MRI. NeuroImage 2009;48:29–36.CrossRefGoogle ScholarPubMed
86. Cherubini, A, Péran, P, Spoletini, I et al. Combined volumetry and DTI in subcortical structures of mild cognitive impairment and Alzheimer’s disease patients. J Alzheimers Dis 2010;19:1273–1282.Google Scholar
87. Eustache, P, Nemmi, F, Saint-Aubert, L, Pariente, J, Péran, P. multimodal magnetic resonance imaging in Alzheimer’s disease patients at prodromal stage. J Alzheimers Dis 2016;50:1035–1050.Google Scholar
88. Spoletini, I, Cherubini, A, Banfi, G et al. Hippocampi, thalami, and accumbens microstructural damage in schizophrenia: a volumetry, diffusivity, and neuropsychological study. Schizophr Bull 2011;37:118–130.Google Scholar
89. Cerasa, A, Cherubini, A, Peran, P, Cerasa, A, Cherubini, A, Peran, P. Multimodal MRI in neurodegenerative disorders, multimodal MRI in neurodegenerative disorders. Neurol Res Int Neurol Res Int 2011;2012:1–2. e287891.Google ScholarPubMed