Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-24T13:41:23.239Z Has data issue: false hasContentIssue false

Neuroplastic Effects of Electroconvulsive Therapy in the Prefrontal-limbic Network of Drug Resistant Depression: a Whole-brain Longitudinal SMRI Study

Published online by Cambridge University Press:  15 April 2020

N. Cardoner
Affiliation:
IDIBELL-Neuroscience Group-Psychiatry, Hospital Universitary de Bellvitge, Barcelona, Spain
M. Valenzuela
Affiliation:
Regenerative Neuroscience Group Brain and Mind Research Institute, University of Sydney, Sydney, Australia
I. Martínez-Zalacain
Affiliation:
IDIBELL-Neuroscience Group-Psychiatry, Hospital Universitary de Bellvitge, Barcelona, Spain
M. Cano
Affiliation:
IDIBELL-Neuroscience Group-Psychiatry, Hospital Universitary de Bellvitge, Barcelona, Spain
C. Loo
Affiliation:
George Hospital Black Dog Institute, University of New South Wales, Sydney, Australia
H. Hallock
Affiliation:
Regenerative Neuroscience Group Brain and Mind Research Institute, University of Sydney, Sydney, Australia
E. Via
Affiliation:
IDIBELL-Neuroscience Group-Psychiatry, Hospital Universitary de Bellvitge, Barcelona, Spain
V. Galvez
Affiliation:
George Hospital Black Dog Institute, University of New South Wales, Sydney, Australia
J. Pujol
Affiliation:
CRC-MAR MRI research Unit, Hospital del Mar, Barcelona, Spain
M. Urretavizcaya
Affiliation:
IDIBELL-Neuroscience Group-Psychiatry, Hospital Universitary de Bellvitge, Barcelona, Spain
J. Menchon
Affiliation:
IDIBELL-Neuroscience Group-Psychiatry, Hospital Universitary de Bellvitge, Barcelona, Spain
C. Soriano-Mas
Affiliation:
IDIBELL-Neuroscience Group-Psychiatry, Hospital Universitary de Bellvitge, Barcelona, Spain

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background

Electroconvulsive therapy (ECT) is the most effective and fast acting therapy for treatment-resistant depression (TRD). Animal research has consistently pointed to neuroplasticity as a central mechanism of ECT action (1), however evidence in humans remains scarce (2; 3).

Method

We assessed two independent samples of TRD patients referred for ECT. The Barcelona-sample included 13 subjects treated with bitemporal ECT and 10 healthy volunteers (HV). Four successive 3T structural MRIs were acquired: baseline, 24-48 hours after the 1st ECT session, 24-48 hours after the 9th ECT, and two weeks after ECT course completion. HV were scanned twice five weeks apart. Within the framework of the Barcelona-Sydney Clinical Imaging Collaboration, we also scanned 10 patients treated mainly with right unilateral ECT (Sydney-sample). Whole-brain longitudinal grey matter (GM) changes were measured using intra-subject diffeomorphic registration, within SPM12b.

Results

In the Barcelona-sample, over the course of treatment bitemporal ECT produced a linear increase of GM volume in the limbic system (involving bilateral hippocampi and amygdalae). Additionally, volumetric increase within the right subgenual cortex was detected from baseline to the 9th ECT session. Such volume changes were not observed in HV. Furthermore, GM volume expansion correlated positively with depressive symptom improvement and neurocognitive performance (memory and executive function). Hippocampal and amygdalar volume increases were replicated in the Sydney-sample, although limited to the stimulated hemisphere.

Conclusions

ECT effects described here could be accounted for by the induction of regionally specific structural plasticity. Nevertheless, other mechanisms such as neurovascular changes should not be discarded.

Type
Article: 1488
Copyright
Copyright © European Psychiatric Association 2015
Submit a response

Comments

No Comments have been published for this article.