Association of electroconvulsive therapy-induced structural plasticity with clinical remission

Akihiro Takamiya, Taishiro Kishimoto, Jinichi Hirano, Toshiaki Kikuchi, Bun Yamagata, Masaru Mimura

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Electroconvulsive therapy (ECT) is the most effective treatment for severe depression. Recent neuroimaging studies have consistently reported that ECT induces volume increases in widely distributed brain regions. However, it still remains unclear about ECT-induced volume changes associated with clinical improvement. Methods: Longitudinal assessments of structural magnetic resonance imaging were conducted in 48 participants. Twenty-seven elderly melancholic depressed individuals (mean 67.5 ± 8.1 years old; 19 female) were scanned before (TP1) and after (TP2) ECT. Twenty-one healthy controls were also scanned twice. Whole-brain gray matter volume (GMV) was analyzed via group (remitters, nonremitters, and controls) by time (TP1 and TP2) analysis of covariance to identify ECT-related GMV changes and GMV changes specific to remitters. Within-subject and between-subjects correlation analyses were conducted to investigate the associations between clinical improvement and GMV changes. Depressive symptoms were evaluated using the 17-item Hamilton Depression Rating Scale (HAM-D), and remission was defined as HAM-D total score ≤ 7. Results: Bilateral ECT increased GMV in multiple brain regions bilaterally regardless of clinical improvement. Remitters showed a larger GMV increase in the right-lateralized frontolimbic brain regions compared to nonremitters and healthy controls. GMV changes in the right hippocampus/amygdala and right middle frontal gyrus showed correlations with clinical improvement in within−/between-subjects correlation analyses. Conclusions: ECT-induced GMV increase in the right frontolimbic regions was associated with clinical remission.

Original languageEnglish
Article number110286
JournalProgress in Neuro-Psychopharmacology and Biological Psychiatry
Volume110
DOIs
Publication statusPublished - 2021 Aug 30

Keywords

  • Depression
  • Electroconvulsive therapy (ECT)
  • Gray matter volume (GMV)
  • Magnetic resonance imaging (MRI)
  • Remission

ASJC Scopus subject areas

  • Pharmacology
  • Biological Psychiatry

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