Structural changes induced by electroconvulsive therapy are associated with clinical outcome.

Autor: Mulders PCR; Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands. Electronic address: petercr.mulders@radboudumc.nl., Llera A; Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands; Radboud University Nijmegen, Nijmegen, the Netherlands., Beckmann CF; Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands; Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB), University of Oxford, Oxford, United Kingdom., Vandenbulcke M; Department of Geriatric Psychiatry, University Psychiatric Center (UPC), KU Leuven, Leuven, Belgium., Stek M; GGZ InGeest Specialized Mental Health Care, Amsterdam, Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands., Sienaert P; Academic Center for ECT and Neurostimulation (AcCENT), University Psychiatric Center (UPC) - KU Leuven, Kortenberg, Belgium., Redlich R; Department of Psychiatry, University of Münster, Münster, Germany., Petrides G; - Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, USA; Center for Neuroscience, Feinstein Institute for Medical Research, Manhasset, USA; Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry, Hempstead, USA., Oudega ML; GGZ InGeest Specialized Mental Health Care, Amsterdam, Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands., Oltedal L; Department of Clinical Medicine, University of Bergen, Bergen, Norway; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway., Oedegaard KJ; Department of Clinical Medicine, University of Bergen, Bergen, Norway; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway., Narr KL; Departments of Neurology Psychiatry, Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, CA, USA., Magnusson PO; Lund University, Box 118, SE-221 00, Lund, Sweden; Previous: Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark., Kessler U; Department of Clinical Medicine, University of Bergen, Bergen, Norway; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway., Jorgensen A; Psychiatric Center Copenhagen & University of Copenhagen, Copenhagen, Denmark., Espinoza R; Departments of Neurology Psychiatry, Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, CA, USA., Enneking V; Department of Psychiatry, University of Münster, Münster, Germany., Emsell L; Department of Geriatric Psychiatry, University Psychiatric Center (UPC), KU Leuven, Leuven, Belgium., Dols A; GGZ InGeest Specialized Mental Health Care, Amsterdam, Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands., Dannlowski U; Department of Psychiatry, University of Münster, Münster, Germany., Bolwig TG; Previous: Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark., Bartsch H; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway; Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA., Argyelan M; - Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, USA; Center for Neuroscience, Feinstein Institute for Medical Research, Manhasset, USA; Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry, Hempstead, USA., Anand A; Center of Behavioral Health, Cleveland Clinic, Cleveland, OH, USA., Abbott CC; Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA., van Eijndhoven PFP; Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands., Tendolkar I; Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, the Netherlands; Department of Psychiatry and Psychotherapy, University Hospital Essen, Essen, Germany.
Jazyk: angličtina
Zdroj: Brain stimulation [Brain Stimul] 2020 May - Jun; Vol. 13 (3), pp. 696-704. Date of Electronic Publication: 2020 Feb 21.
DOI: 10.1016/j.brs.2020.02.020
Abstrakt: Background: Electroconvulsive therapy (ECT) is the most effective treatment option for major depressive disorder, so understanding whether its clinical effect relates to structural brain changes is vital for current and future antidepressant research.
Objective: To determine whether clinical response to ECT is related to structural volumetric changes in the brain as measured by structural magnetic resonance imaging (MRI) and, if so, which regions are related to this clinical effect. We also determine whether a similar model can be used to identify regions associated with electrode placement (unilateral versus bilateral ECT).
Methods: Longitudinal MRI and clinical data (Hamilton Depression Rating Scale) was collected from 10 sites as part of the Global ECT-MRI research collaboration (GEMRIC). From 192 subjects, relative changes in 80 (sub)cortical areas were used as potential features for classifying treatment response. We used recursive feature elimination to extract relevant features, which were subsequently used to train a linear classifier. As a validation, the same was done for electrode placement. We report accuracy as well as the structural coefficients of regions included in the discriminative spatial patterns obtained.
Results: A pattern of structural changes in cortical midline, striatal and lateral prefrontal areas discriminates responders from non-responders (75% accuracy, p < 0.001) while left-sided mediotemporal changes discriminate unilateral from bilateral electrode placement (81% accuracy, p < 0.001).
Conclusions: The identification of a multivariate discriminative pattern shows that structural change is relevant for clinical response to ECT, but this pattern does not include mediotemporal regions that have been the focus of electroconvulsive therapy research so far.
Competing Interests: Declaration of competing interest The authors report no conflict of interest.
(Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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