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Volume of hippocampus-amygdala transition area predicts outcomes of electroconvulsive therapy in major depressive disorder: high accuracy validated in two independent cohorts

Published online by Cambridge University Press:  23 May 2022

Jinping Xu ,
Wenfei Li ,
Tongjian Bai ,
Jiaying Li ,
Jinhuan Zhang ,
Qingmao Hu ,
Jiaojian Wang ,
Yanghua Tian  and
Kai Wang
Jinping Xu
Affiliation:
Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
Wenfei Li
Affiliation:
Affiliated Psychological Hospital of Anhui Medical University, Hefei 230022 China
Tongjian Bai
Affiliation:
Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China
Jiaying Li
Affiliation:
Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
Jinhuan Zhang
Affiliation:
Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
Qingmao Hu
Affiliation:
Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
Jiaojian Wang
Affiliation:
Key Laboratory of Biological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400030, China
Yanghua Tian*
Affiliation:
Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China Department of Neurology, the Second Hospital of Anhui Medical University, Hefei 230022, China Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230022, China Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China Anhui Medical University, School of Mental Health and Psychological Sciences, Hefei 230022, China
Kai Wang
Affiliation:
Department of Neurology, The First Hospital of Anhui Medical University, Hefei, 230022, China Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230022, China Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China Anhui Medical University, School of Mental Health and Psychological Sciences, Hefei 230022, China Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China Anhui Province clinical research center for neurological disease, Hefei 230022, China
*
Authors for correspondence: Yanghua Tian, E-mail: ayfytyh@126.com; Jiaojian Wang, E-mail: jiaojianwang@uestc.edu.cn
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Abstract

Background

Although many previous studies reported structural plasticity of the hippocampus and amygdala induced by electroconvulsive therapy (ECT) in major depressive disorder (MDD), yet the exact roles of both areas for antidepressant effects are still controversial.

Methods

In the current study, segmentation of amygdala and hippocampal sub-regions was used to investigate the longitudinal changes of volume, the relationship between volume and antidepressant effects, and prediction performances for ECT in MDD patients before and after ECT using two independent datasets.

Results

As a result, MDD patients showed selectively and consistently increased volume in the left lateral nucleus, right accessory basal nucleus, bilateral basal nucleus, bilateral corticoamygdaloid transition (CAT), bilateral paralaminar nucleus of the amygdala, and bilateral hippocampus-amygdala transition area (HATA) after ECT in both datasets, whereas marginally significant increase of volume in bilateral granule cell molecular layer of the head of dentate gyrus, the bilateral head of cornu ammonis (CA) 4, and left head of CA 3. Correlation analyses revealed that increased volume of left HATA was significantly associated with antidepressant effects after ECT. Moreover, volumes of HATA in the MDD patients before ECT could be served as potential biomarkers to predict ECT remission with the highest accuracy of 86.95% and 82.92% in two datasets (The predictive models were trained on Dataset 2 and the sensitivity, specificity and accuracy of Dataset 2 were obtained from leave-one-out-cross-validation. Thus, they were not independent and very likely to be inflated).

Conclusions

These results not only suggested that ECT could selectively induce structural plasticity of the amygdala and hippocampal sub-regions associated with antidepressant effects of ECT in MDD patients, but also provided potential biomarkers (especially HATA) for effectively and timely interventions for ECT in clinical applications.

Keywords

Amygdalaelectroconvulsive therapyhippocampusmajor depressive disorderstructure MRIsupport vector machine
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 10 , July 2023 , pp. 4464 - 4473
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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Footnotes

*

These authors contributed equally in the current study.

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