Relationship Between Hippocampal Volume, Serum BDNF, and Depression Severity Following Electroconvulsive Therapy in Late-Life Depression.
Recent structural imaging studies have described hippocampal volume changes following electroconvulsive therapy (ECT). It has been proposed that serum brain-derived neurotrophic factor (sBDNF)-mediated neuroplasticity contributes critically to brain changes following antidepressant treatment. To date no studies have investigated the relationship between changes in hippocampal volume, mood, and sBDNF following ECT. Here, we combine these measurements in a longitudinal study of severe late-life unipolar depression (LLD). We treated 88 elderly patients with severe LLD twice weekly until remission (Montgomery-Åsberg Depression Rating Scale (MADRS) <10). sBDNF and MADRS were obtained before ECT (T0), after the sixth ECT (T1), 1 week after the last ECT (T2), 4 weeks after the last ECT (T3), and 6 months after the last ECT (T4). Hippocampal volumes were quantified by manual segmentation of 3T structural magnetic resonance images in 66 patients at T0 and T2 and in 23 patients at T0, T2, and T4. Linear mixed models (LMM) were used to examine the evolution of MADRS, sBDNF, and hippocampal volume over time. Following ECT, there was a significant decrease in MADRS scores and a significant increase in hippocampal volume. Hippocampal volume decreased back to baseline values at T4. Compared with T0, sBDNF levels remained unchanged at T1, T2, and T3. There was no coevolution between changes in MADRS scores, hippocampal volume, and sBDNF. Hippocampal volume increase following ECT is an independent neurobiological effect unrelated to sBDNF and depressive symptomatology, suggesting a complex mechanism of action of ECT in LLD.
KU Leuven, University Psychiatric Center KU Leuven, Old-age Psychiatry, Kortenberg, Belgium.
Filip
F
Bouckaert
Department of Psychiatry and the EMGO+ Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
Annemiek
A
Dols
KU Leuven, University Psychiatric Center KU Leuven, Old-age Psychiatry, Kortenberg, Belgium.|Division of Translational MRI, Department of Imaging and Pathology, KU Leuven, Radiology, University Hospitals Leuven, University Psychiatric Center KU Leuven, Leuven, Belgium.
Louise
L
Emsell
KU Leuven, University Psychiatric Center KU Leuven, Old-age Psychiatry, Kortenberg, Belgium.
François-Laurent
FL
De Winter
Department of Statistics, KU Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium.
Kristof
K
Vansteelandt
Division of Translational MRI, Department of Imaging and Pathology, KU Leuven, Radiology, University Hospitals Leuven, University Psychiatric Center KU Leuven, Leuven, Belgium.
Lene
L
Claes
Division of Translational MRI, Department of Imaging and Pathology, KU Leuven, Radiology, University Hospitals Leuven, University Psychiatric Center KU Leuven, Leuven, Belgium.
Stefan
S
Sunaert
Department of Psychiatry and the EMGO+ Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
Max
M
Stek
Academic Center for ECT and Neuromodulation, KU Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium.
Pascal
P
Sienaert
KU Leuven, University Psychiatric Center KU Leuven, Old-age Psychiatry, Kortenberg, Belgium.
Mathieu
M
Vandenbulcke
D000368:Aged; D000369:Aged, 80 and over; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D003863:Depression / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000379:methods; D005260:Female; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D013223:Statistics as Topic; D013997:Time Factors; D016896:Treatment Outcome
D019208:Brain-Derived Neurotrophic Factor; C579455:BDNF protein, human