title: Effect of Electroconvulsive Therapy on Striatal Morphometry in Major Depressive Disorder.
abstract: Patients with major depression show reductions in striatal and paleostriatal volumes. The functional integrity and connectivity of these regions are also shown to change with antidepressant response. Electroconvulsive therapy (ECT) is a robust and rapidly acting treatment for severe depression. However, whether morphological changes in the dorsal and ventral striatum/pallidum relate to or predict therapeutic response to ECT is unknown. Using structural MRI, we assessed cross-sectional effects of diagnosis and longitudinal effects of ECT for volume and surface-based shape metrics of the caudate, putamen, pallidum, and nucleus accumbens in 53 depressed patients (mean age: 44.1 years, 13.8 SD; 52% female) and 33 healthy controls (mean age: 39.3 years, 12.4 SD; 57% female). Patients were assessed before ECT, after their second ECT, and after completing an ECT treatment index. Controls were evaluated at two time points. Support vector machines determined whether morphometric measures at baseline predicted ECT-related clinical response. Patients showed smaller baseline accumbens and pallidal volumes than controls (P<0.05). Increases in left putamen volume (P<0.03) occurred with ECT. Global increases in accumbens volume and local changes in pallidum and caudate volume occurred in patients defined as treatment responders. Morphometric changes were absent across time in controls. Baseline volume and shape metrics predicted overall response to ECT with up to 89% accuracy. Results support that ECT elicits structural plasticity in the dorsal and ventral striatum/pallidum. The morphometry of these structures, forming key components of limbic-cortical-striatal-pallidal-thalamic circuitry involved in mood and emotional regulation, may determine patients likely to benefit from treatment.
authors.affiliation: Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA.
authors.forename: Benjamin S C
authors.initials: BS
authors.lastname: Wade
authors.affiliation: Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA.
authors.forename: Shantanu H
authors.initials: SH
authors.lastname: Joshi
authors.affiliation: Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Njau
authors.affiliation: Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA.
authors.forename: Amber M
authors.initials: AM
authors.lastname: Leaver
authors.affiliation: Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA.
authors.forename: Megha
authors.initials: M
authors.lastname: Vasavada
authors.affiliation: Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA.|Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA.
authors.forename: Roger P
authors.initials: RP
authors.lastname: Woods
authors.affiliation: Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA.
authors.forename: Boris A
authors.initials: BA
authors.lastname: Gutman
authors.affiliation: Imaging Genetics Center, University of Southern California, Los Angeles, CA, USA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Thompson
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA.
authors.forename: Randall
authors.identifier: 0000-0003-2895-4212
authors.initials: R
authors.lastname: Espinoza
authors.affiliation: Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA.|Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA, USA.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Narr
mesh_terms: D000328:Adult; D019540:Area Under Curve; D003342:Corpus Striatum / Q000000981:diagnostic imaging / Q000473:pathology*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013997:Time Factors; D016896:Treatment Outcome