Effects of ECT in treatment of depression: study protocol for a prospective neuroradiological study of acute and longitudinal effects on brain structure and function.
BACKGROUND
Major depression can be a serious and debilitating condition. For some patients in a treatment resistant depressive episode, electroconvulsive treatment (ECT) is the only treatment that is effective. Although ECT has shown efficacy in randomized controlled trials, the treatment is still controversial and stigmatized. This can in part be attributed to our lack of knowledge of the mechanisms of action. Some reports also suggest potential harmful effects of ECT treatment and memory related side effects have been documented.


METHODS
The present study will apply state of the art radiology through advanced magnetic resonance imaging (MRI) techniques to investigate structural and functional brain effects of ECT. As a multi-disciplinary collaboration, imaging findings will be correlated to psychiatric response parameters, neuropsychological functioning as well as neurochemical and genetic biomarkers that can elucidate the underlying mechanisms. The aim is to document both treatment effects and potential harmful effects of ECT.


METHODS
n = 40 patients in a major depressive episode (bipolar and major depressive disorder). Two control groups with n = 15 in each group: age and gender matched healthy volunteers not receiving ECT and patients undergoing electrical cardioversion (ECV) for atrial fibrillation (AF). Observation time: six months.


CONCLUSIONS
The study will contribute to our understanding of the pathophysiology of major depression as well as mechanisms of action for the most effective treatment for the disorder; ECT.
Department of Radiology, Haukeland University Hospital, Bergen, Norway. leif.oltedal@k1.uib.no.|Department of Clinical Medicine, University of Bergen, Bergen, Norway. leif.oltedal@k1.uib.no.
Leif
L
Oltedal
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway. ute.kessler@helse-bergen.no.
Ute
U
Kessler
Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway. lars.ersland@helse-bergen.no.
Lars
L
Ersland
Department of Radiology, Haukeland University Hospital, Bergen, Norway. renate@fmri.no.
Renate
R
Grüner
NORMENT, KG Jebsen Centre, Oslo University Hospital and University of Oslo, Oslo, Norway. o.a.andreassen@medisin.uio.no.
Ole A
OA
Andreassen
K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway. Jan.Haavik@biomed.uib.no.
Jan
J
Haavik
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway. per.ivar.hoff@helse-bergen.no.
Per Ivar
PI
Hoff
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway. aasa.Hammar@uib.no.|Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway. aasa.Hammar@uib.no.
Åsa
Å
Hammar
Departments of Neurosciences, Radiology and Psychiatry, University of California, San Diego, CA, USA. andersmdale@gmail.com.|Multimodal Imaging Laboratory, University of California, San Diego, CA, USA. andersmdale@gmail.com.
Anders M
AM
Dale
Department of Radiology, Haukeland University Hospital, Bergen, Norway. Hugdahl@psybp.uib.no.|Division of Psychiatry, Haukeland University Hospital, Bergen, Norway. Hugdahl@psybp.uib.no.|Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway. Hugdahl@psybp.uib.no.
Kenneth
K
Hugdahl
Department of Clinical Medicine, University of Bergen, Bergen, Norway. ketil.odegaard@helse-bergen.no.|Division of Psychiatry, Haukeland University Hospital, Bergen, Norway. ketil.odegaard@helse-bergen.no.|K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway. ketil.odegaard@helse-bergen.no.
Ketil J
KJ
Oedegaard
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001921:Brain / Q000473:pathology*; D002985:Clinical Protocols; D003865:Major Depressive Disorder / Q000097:blood / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects* / Q000523:psychology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D009483:Neuropsychological Tests; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers