Brain Plasticity After ECT Versus Antidepressant Medication: MRI Study From Switzerland

Out on PubMed, from investigators in Switzerland, is this study:

Distinct and shared patterns of brain plasticity during electroconvulsive therapy and treatment as usual in depression: an observational multimodal MRI-study.

Bracht T, Walther S, Breit S, Mertse N, Federspiel A, Meyer A, Soravia LM, Wiest R, Denier N.Transl Psychiatry. 2023 Jan 10;13(1):6. doi: 10.1038/s41398-022-02304-2.PMID: 36627288

The abstract is copied below:

Electroconvulsive therapy (ECT) is a highly effective treatment for depression. Previous studies point to ECT-induced volume increase in the hippocampi and amygdalae, and to increase in cortical thickness. However, it is unclear if these neuroplastic changes are associated with treatment response. This observational study aimed to address this research question by comparing neuroplasticity between patients with depression receiving ECT and patients with depression that respond to treatment as usual (TAU-responders). Twenty ECT-patients (16 major depressive disorder (MDD), 4 depressed bipolar disorder), 20 TAU-responders (20 MDD) and 20 healthy controls (HC) were scanned twice with multimodal magnetic resonance imaging (structure: MP2RAGE; perfusion: arterial spin labeling). ECT-patients were scanned before and after an ECT-index series (ECT-group). TAU-responders were scanned during a depressive episode and following remission or treatment response. Volumes and cerebral blood flow (CBF) of the hippocampi and amygdalae, and global mean cortical thickness were compared between groups. There was a significant group × time interaction for hippocampal and amygdalar volumes, CBF in the hippocampi and global mean cortical thickness. Hippocampal and amygdalar enlargements and CBF increase in the hippocampi were observed in the ECT-group but neither in TAU-responders nor in HC. Increase in global mean cortical thickness was observed in the ECT-group and in TAU-responders but not in HC. The co-occurrence of increase in global mean cortical thickness in both TAU-responders and in ECT-patients may point to a shared mechanism of antidepressant response. This was not the case for subcortical volume and CBF increase.

The article is here.

And from the text:

This a small, but interesting, study comparing structural brain changes and CBF in 3 groups: ECT patients, antidepressant medication ("TAU") patients and healthy controls. Most of the changes are more robust with ECT (no surprise there); the overlapping changes are quite interesting. It's still too early to commit the details to memory since they will likely change, but the direction of this research is the exciting second wave of neuroimaging research: finding the correlations with clinical response. Also, figuring out which brain components are actually changing (see yellow text, upper right  above) will be important and fascinating.