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Structural changes induced by electroconvulsive therapy are associated with clinical outcome

Mulders, Peter C.R. ; Llera, Alberto ; Beckmann, Christian F. ; Vandenbulcke, Mathieu ; Stek, Max ; Sienaert, Pascal ; Redlich, Ronny ; Petrides, Georgios ; Oudega, Mardien Leoniek and Oltedal, Leif , et al. (2020) In Brain Stimulation 13(3). p.696-704
Abstract

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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Depression, Electroconvulsive therapy, Major depressive disorder, MRI
in
Brain Stimulation
volume
13
issue
3
pages
9 pages
publisher
Elsevier
external identifiers
  • pmid:32289700
  • scopus:85079844220
ISSN
1935-861X
DOI
10.1016/j.brs.2020.02.020
language
English
LU publication?
yes
id
8a0ee6ca-a9b1-4646-ad47-38e577f7368a
date added to LUP
2020-03-09 14:31:16
date last changed
2024-06-13 12:35:40
@article{8a0ee6ca-a9b1-4646-ad47-38e577f7368a,
  abstract     = {{<p>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 &lt; 0.001) while left-sided mediotemporal changes discriminate unilateral from bilateral electrode placement (81% accuracy, p &lt; 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.</p>}},
  author       = {{Mulders, Peter C.R. and Llera, Alberto and Beckmann, Christian F. and Vandenbulcke, Mathieu and Stek, Max and Sienaert, Pascal and Redlich, Ronny and Petrides, Georgios and Oudega, Mardien Leoniek and Oltedal, Leif and Oedegaard, Ketil J. and Narr, Katherine L. and Magnusson, Peter O. and Kessler, Ute and Jorgensen, Anders and Espinoza, Randall and Enneking, Verena and Emsell, Louise and Dols, Annemieke and Dannlowski, Udo and Bolwig, Tom G. and Bartsch, Hauke and Argyelan, Miklos and Anand, Amit and Abbott, Christopher C. and van Eijndhoven, Philip F.P. and Tendolkar, Indira}},
  issn         = {{1935-861X}},
  keywords     = {{Depression; Electroconvulsive therapy; Major depressive disorder; MRI}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{696--704}},
  publisher    = {{Elsevier}},
  series       = {{Brain Stimulation}},
  title        = {{Structural changes induced by electroconvulsive therapy are associated with clinical outcome}},
  url          = {{http://dx.doi.org/10.1016/j.brs.2020.02.020}},
  doi          = {{10.1016/j.brs.2020.02.020}},
  volume       = {{13}},
  year         = {{2020}},
}