Gray Matter Volume Associated with Clinical Outcome in Geriatric Depression: Small Study from Japan

Out on PubMed, from researchers in Japan, is this study:

Association of electroconvulsive therapy-induced structural plasticity with clinical remission.

Takamiya A, Kishimoto T, Hirano J, Kikuchi T, Yamagata B, Mimura M.Prog Neuropsychopharmacol Biol Psychiatry. 2021 Feb 20:110286. doi: 10.1016/j.pnpbp.2021.110286. Online ahead of print.PMID: 33621611
The abstract is copied below:

Background: Electroconvulsive therapy (ECT) is the most effective treatment for severe depression. Recent neuroimaging studies have consistently reported that ECT induces volume increases in widely distributed brain regions. However, it still remains unclear about ECT-induced volume changes associated with clinical improvement.

Methods: Longitudinal assessments of structural magnetic resonance imaging were conducted in 48 participants. Twenty-seven elderly melancholic depressed individuals (mean 67.5 ± 8.1 years old; 19 female) were scanned before (TP1) and after (TP2) ECT. Twenty-one healthy controls were also scanned twice. Whole-brain gray matter volume (GMV) was analysed via group (remitters, nonremitters, and controls) by time (TP1 and TP2) analysis of covariance to identify ECT-related GMV changes and GMV changes specific to remitters. Within-subject and between-subjects correlation analyses were conducted to investigate the associations between clinical improvement and GMV changes. Depressive symptoms were evaluated using the 17-item Hamilton Depression Rating Scale (HAMD), and remission was defined as HAM-D total score ≤ 7.

Results: Bilateral ECT increased GMV in multiple brain regions bilaterally regardless of clinical improvement. Remitters showed a larger GMV increase in the right-lateralized frontolimbic brain regions compared to nonremitters and healthy controls. GMV changes in the right hippocampus/amygdala and right middle frontal gyrus showed correlations with clinical improvement in within-/between-subjects correlation analyses.

Conclusions: ECT-induced GMV increase in the right frontolimbic regions was associated with clinical remission.

Keywords: Depression; Electroconvulsive therapy (ECT); Gray matter volume (GMV); Magnetic resonance imaging (MRI); Remission.

and from the text:


and a figure:

This study looked at structural brain changes in 27 patients with late-life melancholic depression who had MRIs one week before, and one week after, a course of bilateral ECT.
It was only a matter of time before a neuroimaging study would report a correlation between brain regional structural changes and clinical outcome. Here, the remission-associated regions are right frontolimbic (hippocampus, amygdala, middle frontal gyrus).
This is a well-presented study that seems to move the needle of evidence a little bit in a good direction; what will be needed, of course, is replication in larger samples. Hopefully the ongoing wok of the large ECT neuroimaging consortia will provide this.
This paper is worth a full read, particularly for those wanting to stay current with ECT neuroimaging research,~20 minutes.


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