Gregor Gryglewski1, Rupert Lanzenberger1, Leo R Silberbauer1, Daniel Pacher1, Siegfried Kasper2, Rainer Rupprecht3, Richard Frey1, Pia Baldinger-Melich4. 1. Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry, Medical University of Vienna, Austria. 2. Center for Brain Research, Medical University of Vienna, Austria. 3. Department of Psychiatry and Psychotherapy, University of Regensburg, Germany. 4. Department of Psychiatry and Psychotherapy, Clinical Division of General Psychiatry, Medical University of Vienna, Austria. Electronic address: pia.baldinger-melich@meduniwien.ac.at.
Abstract
BACKGROUND: Increases in the volume of the amygdala and hippocampus after electroconvulsive therapy (ECT) are among the most robust effects known to the brain-imaging field. Recent advances in the segmentation of substructures of these regions allow for novel insights on the relationship between brain structure and clinical outcomes of ECT. OBJECTIVE: We aimed to provide a comprehensive synthesis of evidence available on changes in brain structure after ECT, including recently published data on hippocampal subfields. METHODS: A meta-analysis of published studies was carried out using random-effects models of standardized mean change of regional brain volumes measured with longitudinal magnetic resonance imaging of depressive patients before and after a series of ECT. RESULTS: Data from 21 studies (543 depressed patients) were analysed, including 6 studies (118 patients) on hippocampal subfields. Meta-analyses could be carried out for seven brain regions for which data from at least three published studies was available. We observed increases in left and right hippocampi, amygdalae, cornua ammonis (CA) 1, CA 2/3, dentate gyri (DG) and subicula with standardized mean change scores ranging between 0.34 and 1.15. The model did not reveal significant volume increases in the caudate. Meta-regression indicated a negative relationship between the reported increases in the DG and relative symptom improvement (-0.27 (SE: 0.09) per 10%). CONCLUSIONS: ECT is accompanied by significant volume increases in the bilateral hippocampus and amygdala that are not associated with treatment outcome. Among hippocampal subfields, the most robust volume increases after ECT were measured in the dentate gyrus. The indicated negative correlation of this effect with antidepressant efficacy warrants replication in data of individual patients.
BACKGROUND: Increases in the volume of the amygdala and hippocampus after electroconvulsive therapy (ECT) are among the most robust effects known to the brain-imaging field. Recent advances in the segmentation of substructures of these regions allow for novel insights on the relationship between brain structure and clinical outcomes of ECT. OBJECTIVE: We aimed to provide a comprehensive synthesis of evidence available on changes in brain structure after ECT, including recently published data on hippocampal subfields. METHODS: A meta-analysis of published studies was carried out using random-effects models of standardized mean change of regional brain volumes measured with longitudinal magnetic resonance imaging of depressivepatients before and after a series of ECT. RESULTS: Data from 21 studies (543 depressed patients) were analysed, including 6 studies (118 patients) on hippocampal subfields. Meta-analyses could be carried out for seven brain regions for which data from at least three published studies was available. We observed increases in left and right hippocampi, amygdalae, cornua ammonis (CA) 1, CA 2/3, dentate gyri (DG) and subicula with standardized mean change scores ranging between 0.34 and 1.15. The model did not reveal significant volume increases in the caudate. Meta-regression indicated a negative relationship between the reported increases in the DG and relative symptom improvement (-0.27 (SE: 0.09) per 10%). CONCLUSIONS: ECT is accompanied by significant volume increases in the bilateral hippocampus and amygdala that are not associated with treatment outcome. Among hippocampal subfields, the most robust volume increases after ECT were measured in the dentate gyrus. The indicated negative correlation of this effect with antidepressant efficacy warrants replication in data of individual patients.
Authors: Akihiro Takamiya; Annemiek Dols; Louise Emsell; Christopher Abbott; Antoine Yrondi; Carles Soriano Mas; Martin Balslev Jorgensen; Pia Nordanskog; Didi Rhebergen; Eric van Exel; Mardien L Oudega; Filip Bouckaert; Mathieu Vandenbulcke; Pascal Sienaert; Patrice Péran; Marta Cano; Narcis Cardoner; Anders Jorgensen; Olaf B Paulson; Paul Hamilton; Robin Kampe; Willem Bruin; Hauke Bartsch; Olga Therese Ousdal; Ute Kessler; Guido van Wingen; Leif Oltedal; Taishiro Kishimoto Journal: Schizophr Bull Date: 2022-03-01 Impact factor: 9.306