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- Title
Grey matter volume increase following electroconvulsive therapy in patients with late life depression: a longitudinal MRI study.
- Authors
Bouckaert, Filip; De Winter, François-Laurent; Emsell, Louise; Dols, Annemieke; Rhebergen, Didi; Wampers, Martien; Sunaert, Stefan; Stek, Max; Sienaert, Pascal; Vandenbulcke, Mathieu
- Abstract
Background: The evidence on the mechanisms of action of electroconvulsive therapy (ECT) has grown over the past decades. Recent studies show an ECT-related increase in hippocampal, amygdala and subgenual cortex volume. We examined grey matter volume changes following ECT using voxel-based morphometry (VBM) whole brain analysis in patients with severe late life depression (LLD). Methods: Elderly patients with unipolar depression were treated twice weekly with right unilateral ECT until remission on the Montgomery-Åsberg Depression Rating Scale (MADRS) was achieved. Cognition (Mini Mental State Examination) and psychomotor changes (CORE Assessment) were monitored at baseline and 1 week after the last session of ECT. We performed 3 T structural MRI at both time points. We used the VBM8 toolbox in SPM8 to study grey matter volume changes. Paired t tests were used to compare pre-and post-ECT grey matter volume (voxel-level family-wise error threshold p < 0.05) and to assess clinical response. Results: Twenty-eight patients (mean age 71.9 ± 7.8 yr, 8 men) participated in our study. Patients received a mean of 11.2 ± 4 sessions of ECT. The remission rate was 78.6%. Cognition, psychomotor agitation and psychomotor retardation improved significantly (p < 0.001). Right-hemispheric grey matter volume was increased in the caudate nucleus, medial temporal lobe (including hippocampus and amygdala), insula and posterior superior temporal regions but did not correlate with MADRS score. Grey matter volume increase in the caudate nucleus region correlated significantly with total CORE Assessment score (r = 0.63; p < 0.001). Limitations: Not all participants were medication-free. Conclusion: Electroconvulsive therapy in patients with LLD is associated with significant grey matter volume increase, which is most pronounced ipsilateral to the stimulation side.
- Subjects
BELGIUM; ANALYSIS of variance; CONFIDENCE intervals; MENTAL depression; ELECTROCONVULSIVE therapy; MAGNETIC resonance imaging; NEUROPSYCHOLOGICAL tests; PSYCHOLOGICAL tests; PSYCHOMOTOR disorders; RESEARCH funding; STATISTICS; T-test (Statistics); DATA analysis; DISEASE remission; DATA analysis software; DESCRIPTIVE statistics; GRAY matter (Nerve tissue); OLD age
- Publication
Journal of Psychiatry & Neuroscience, 2016, Vol 41, Issue 2, p105
- ISSN
1180-4882
- Publication type
Article
- DOI
10.1503/jpn.140322