A Circuit For Depression: New Data From the GEMRIC Consortium

Out on PubMed, from international researchers, is this pre-print:

Electroconvulsive therapy-induced volumetric brain changes converge on a common causal circuit in depression.

Deng ZD, Ousdal OT, Oltedal L, Angulo B, Baradits M, Spitzberg A, Kessler U, Sartorius A, Dols A, Narr K, Espinoza R, Waarde JV, Tendolkar I, van Eijndhoven P, van Wingen G, Takamiya A, Kishimoto T, Jorgensen M, Jorgensen A, Paulson O, Yrondi A, Peran P, Soriano-Mas C, Cardoner N, Cano M, van Diermen L, Schrijvers D, Belge JB, Emsell L, Bouckaert F, Vandenbulcke M, Kiebs M, Hurlemann R, Mulders P, Redlich R, Dannlowski U, Kavakbasi E, Kritzer M, Ellard K, Camprodon J, Petrides G, Maholtra A, Abbott C, Argyelan M.Res Sq. 2023 Jun 1:rs.3.rs-2925196. doi: 10.21203/rs.3.rs-2925196/v1. Preprint.PMID: 37398308

The abstract is copied below:

Neurostimulation is a mainstream treatment option for major depression. Neuromodulation techniques apply repetitive magnetic or electrical stimulation to some neural target but significantly differ in their invasiveness, spatial selectivity, mechanism of action, and efficacy. Despite these differences, recent analyses of transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS)-treated individuals converged on a common neural network that might have a causal role in treatment response. We set out to investigate if the neuronal underpinnings of electroconvulsive therapy (ECT) are similarly associated with this common causal network (CCN). Our aim here is to provide a comprehensive analysis in three cohorts of patients segregated by electrode placement (N = 246 with right unilateral, 79 with bitemporal, and 61 with mixed) who underwent ECT. We conducted a data-driven, unsupervised multivariate neuroimaging analysis (Principal Component Analysis, PCA) of the cortical and subcortical volume changes and electric field (EF) distribution to explore changes within the CCN associated with antidepressant outcomes. Despite the different treatment modalities (ECT vs TMS and DBS) and methodological approaches (structural vs functional networks), we found a highly similar pattern of change within the CCN in the three cohorts of patients (spatial similarity across 85 regions: r = 0.65, 0.58, 0.40, df = 83). Most importantly, the expression of this pattern correlated with clinical outcomes. This evidence further supports that treatment interventions converge on a CCN in depression. Optimizing modulation of this network could serve to improve the outcome of neurostimulation in depression.

The article is here.

And from the text:

So here is another large dataset from GEMRIC.

For this, I prefer to deal with the overarching concepts and not get into the weeds of the details.

The authors posit a neuroanatomic circuit that comprises brain regions implicated in depressive illness. They also note the relationship between electric field (EF) of the ECT stimulus and volumetric change.

But too high or too low EF is not optimal, so it is complicated. And if the EF is key, what does that say about the seizure? Clearly, it is way too early to reach conclusions, but this is impressive research and we look forward to more of it.

One aside: this is a pre-print, not (yet) a peer-reviewed paper. So now one can get something on PubMed BEFORE it is peer reviewed? Seems like a bit of an end run, no?