Characterization of gray matter volume changes from one week to 6 months after termination of electroconvulsive therapy in depressed patients

Maarten Laroy*, Filip Bouckaert, Olga Therese Ousdal, Annemieke Dols, Didi Rhebergen, Eric van Exel, Guido van Wingen, Jeroen van Waarde, Joey Verdijk, Ute Kessler, Hauke Bartsch, Martin Balslev Jorgensen, Olaf B. Paulson, Pia Nordanskog, Joan Prudic, Pascal Sienaert, Mathieu Vandenbulcke, Leif Oltedal, Louise Emsell, for GEMRIC

*Corresponding author for this work

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Abstract

Background: Increased gray matter volume (GMV) following electroconvulsive therapy (ECT) has been well-documented, with limited studies reporting a subsequent decrease in GMV afterwards. Objective: This study characterized the reversion pattern of GMV after ECT and its association with clinical depression outcome, using multi-site triple time-point data from the Global ECT-MRI Research Collaboration (GEMRIC). Methods: 86 subjects from the GEMRIC database were included, and GMV in 84 regions-of-interest (ROI) was obtained from automatic segmentation of T1 MRI images at three timepoints: pre-ECT (T0), within one-week post-ECT (T1), and one to six months post-ECT (T2). RM-ANOVAs were used to assess longitudinal changes and LMM analyses explored associations between GMV changes and demographical and clinical characteristics. Results: 63 of the 84 ROIs showed a significant increase-and-decrease pattern (RM-ANOVA, Bonferroni corrected p < 0.00059). Post hoc tests indicated a consistent pattern in each of these 63 ROIs: significant increase from T0 to T1inGMV, followed by significant decrease from T1 to T2 and no difference between T0 and T2, except for both amygdalae, right hippocampus and pars triangularis, which showed the same increase and decrease but GMV at T2 remained higher compared to T0. No consistent relationship was found between GMV change pattern and clinical status. Conclusion: The GEMRIC cohort confirmed a rapid increase of GMV after ECT followed by reversion of GMV one to six months thereafter. The lack of association between the GMV change pattern and depression outcome scores implies a transient neurobiological effect of ECT unrelated to clinical improvement.

Original languageEnglish
JournalBrain Stimulation
Volume17
Issue number4
Pages (from-to)876-886
Number of pages11
ISSN1935-861X
DOIs
Publication statusPublished - 2024

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© 2024 The Authors

Keywords

  • Brain
  • Depression
  • ECT
  • Magnetic resonance imaging
  • Neuroimaging
  • Neuroplasticity

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