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

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 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.

journal_name

Brain Stimul

journal_title

Brain stimulation

authors

Mulders PCR,Llera A,Beckmann CF,Vandenbulcke M,Stek M,Sienaert P,Redlich R,Petrides G,Oudega ML,Oltedal L,Oedegaard KJ,Narr KL,Magnusson PO,Kessler U,Jorgensen A,Espinoza R,Enneking V,Emsell L,Dols A,Dannlowski U,

doi

10.1016/j.brs.2020.02.020

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

696-704

issue

3

eissn

1935-861X

issn

1876-4754

pii

S1935-861X(20)30042-5

journal_volume

13

pub_type

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