Filip Bouckaert1, Louise Emsell2, Kristof Vansteelandt3, François-Laurent De Winter4, Jan Van den Stock4, Jasmien Obbels5, Annemieke Dols6, Max Stek6, Katarzyna Adamczuk7, Stefan Sunaert8, Koen Van Laere9, Pascal Sienaert5, Mathieu Vandenbulcke4. 1. KU Leuven, University Psychiatric Center KU Leuven, Department of Old Age Psychiatry, Herestraat 49, 3000 Leuven / Leuvensesteenweg 517, 3070 Kortenberg, Belgium. Electronic address: filip.bouckaert@upckuleuven.be. 2. KU Leuven, University Psychiatric Center KU Leuven, Department of Old Age Psychiatry, Herestraat 49, 3000 Leuven / Leuvensesteenweg 517, 3070 Kortenberg, Belgium; Translational MRI, Department of Imaging and Pathology, KU Leuven, Radiology, University Hospitals Leuven, and University Psychiatric Center KU Leuven, Belgium. 3. KU Leuven, University Psychiatric Center KU Leuven, Department of Statistics, Herestraat 49, 3000 Leuven / Leuvensesteenweg 517, 3070 Kortenberg, Belgium. 4. KU Leuven, University Psychiatric Center KU Leuven, Department of Old Age Psychiatry, Herestraat 49, 3000 Leuven / Leuvensesteenweg 517, 3070 Kortenberg, Belgium. 5. KU Leuven, University Psychiatric Center KU Leuven, Academic Center for ECT and Neuromodulation (AcCENT), Leuvensesteenweg 517, 3070 Kortenberg, Belgium. 6. Department of Psychiatry and the EMGO+ Institute for Health and Care Research, VU University Medical Center Amsterdam, the Netherlands. 7. Laboratory of Cognitive Neurology, KU Leuven, Belgium. 8. Translational MRI, Department of Imaging and Pathology, KU Leuven, Radiology, University Hospitals Leuven, and University Psychiatric Center KU Leuven, Belgium. 9. Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven and University Hospitals Leuven, Belgium.
Abstract
BACKGROUND: Gray matter volume decrease, white matter vascular pathology and amyloid accumulation are age-related brain changes that have been related to the pathogenesis of late life depression (LLD). Furthermore, lower hippocampal volume and more white matter hyperintensities (WMH) may contribute to poor response to electroconvulsive therapy (ECT) in severely depressed older adults. We hypothesized that the accumulation of age-related brain changes negatively affects outcome following ECT in LLD. METHODS: 34 elderly patients with severe LLD were treated twice weekly with ECT until remission. All had both 3T structural magnetic resonance imaging (MRI) and β-amyloid positron emission tomography (PET) imaging using 18F-flutemetamol at baseline. MADRS and MMSE were obtained weekly which included 1 week prior to ECT (T0), after the sixth ECT (T1), and one week (T2) after the last ECT as well as at four weeks (T3) and 6 months (T4) after the last ECT. We conducted a multiple logistic regression analysis and a survival analysis with neuroimaging measures as predictors, and response, remission and relapse as outcome variable. RESULTS: We did not find any association between baseline hippocampal volume, white matter hyperintensity volume and total amyloid load and response or remission at 1 and 4 weeks post ECT, nor with relapse at week 4. LIMITATIONS: The present exploratory study was conducted at a single center academic hospital, the sample size was small, the focus was on hippocampal volume and the predictive effect of structural and molecular changes associated with aging were used. CONCLUSIONS: Our study shows no evidence of relationship between response to ECT and age-related structural or molecular brain changes, implying that ECT can be applied effectively in depressed patients irrespective of accumulating age-related brain changes.
BACKGROUND: Gray matter volume decrease, white matter vascular pathology and amyloid accumulation are age-related brain changes that have been related to the pathogenesis of late life depression (LLD). Furthermore, lower hippocampal volume and more white matter hyperintensities (WMH) may contribute to poor response to electroconvulsive therapy (ECT) in severely depressed older adults. We hypothesized that the accumulation of age-related brain changes negatively affects outcome following ECT in LLD. METHODS: 34 elderly patients with severe LLD were treated twice weekly with ECT until remission. All had both 3T structural magnetic resonance imaging (MRI) and β-amyloid positron emission tomography (PET) imaging using 18F-flutemetamol at baseline. MADRS and MMSE were obtained weekly which included 1 week prior to ECT (T0), after the sixth ECT (T1), and one week (T2) after the last ECT as well as at four weeks (T3) and 6 months (T4) after the last ECT. We conducted a multiple logistic regression analysis and a survival analysis with neuroimaging measures as predictors, and response, remission and relapse as outcome variable. RESULTS: We did not find any association between baseline hippocampal volume, white matter hyperintensity volume and total amyloid load and response or remission at 1 and 4 weeks post ECT, nor with relapse at week 4. LIMITATIONS: The present exploratory study was conducted at a single center academic hospital, the sample size was small, the focus was on hippocampal volume and the predictive effect of structural and molecular changes associated with aging were used. CONCLUSIONS: Our study shows no evidence of relationship between response to ECT and age-related structural or molecular brain changes, implying that ECT can be applied effectively in depressedpatients irrespective of accumulating age-related brain changes.
Authors: Dore Loef; Kristof Vansteelandt; Mardien L Oudega; Philip van Eijndhoven; Angela Carlier; Eric van Exel; Didi Rhebergen; Pascal Sienaert; Mathieu Vandenbulcke; Filip Bouckaert; Annemiek Dols Journal: Brain Behav Immun Health Date: 2021-11-16
Authors: Machteld A J T Blanken; Mardien L Oudega; Sigfried N T M Schouws; Jeroen S van Zanten; Jennifer R Gatchel; William T Regenold; Annemiek Dols Journal: Bipolar Disord Date: 2020-10-09 Impact factor: 6.744