title: Electroconvulsive therapy-induced brain plasticity determines therapeutic outcome in mood disorders.
abstract: There remains much scientific, clinical, and ethical controversy concerning the use of electroconvulsive therapy (ECT) for psychiatric disorders stemming from a lack of information and knowledge about how such treatment might work, given its nonspecific and spatially unfocused nature. The mode of action of ECT has even been ascribed to a "barbaric" form of placebo effect. Here we show differential, highly specific, spatially distributed effects of ECT on regional brain structure in two populations: patients with unipolar or bipolar disorder. Unipolar and bipolar disorders respond differentially to ECT and the associated local brain-volume changes, which occur in areas previously associated with these diseases, correlate with symptom severity and the therapeutic effect. Our unique evidence shows that electrophysical therapeutic effects, although applied generally, take on regional significance through interactions with brain pathophysiology.
authors.affiliation: Laboratoire de Recherche en Neuroimagerie, Département des Neurosciences Cliniques-Centre Hospitalier Universitaire Vaudois, Université de Lausanne, 1011 Lausanne, Switzerland.
authors.forename: Juergen
authors.initials: J
authors.lastname: Dukart
authors.forename: Francesca
authors.initials: F
authors.lastname: Regen
authors.forename: Ferath
authors.initials: F
authors.lastname: Kherif
authors.forename: Michael
authors.initials: M
authors.lastname: Colla
authors.forename: Malek
authors.initials: M
authors.lastname: Bajbouj
authors.forename: Isabella
authors.initials: I
authors.lastname: Heuser
authors.forename: Richard S
authors.initials: RS
authors.lastname: Frackowiak
authors.forename: Bogdan
authors.initials: B
authors.lastname: Draganski
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy; D001931:Brain Mapping; D046690:Deep Brain Stimulation / Q000379:methods; D003863:Depression / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000379:methods*; D004594:Electrophysiology; D005189:False Positive Reactions; D005260:Female; D006624:Hippocampus / Q000378:metabolism; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000503:physiopathology* / Q000628:therapy*; D009473:Neuronal Plasticity; D016896:Treatment Outcome
keywords: hippocampus; magnetic resonance imaging; unipolar depression; voxel-based morphometry