title: Structural network changes in patients with major depression and schizophrenia treated with electroconvulsive therapy.
abstract: Electroconvulsive therapy (ECT) is one of the most effective treatments in severe and treatment-resistant major depressive disorder (MDD). In schizophrenia (SZ), ECT is frequently considered in drug-resistant cases, as an augmentation of antipsychotic treatment or in cases when rapid symptom relief is indicated. Accumulating neuroimaging evidence suggests modulation of medial temporal lobe and prefrontal cortical regions in MDD by ECT. In SZ, ECT-effects on brain structure have not been systematically investigated so far. In this study, we investigated brain volume in 21 ECT-naïve patients (12 with MDD, 9 with SZ) who received right-sided unilateral ECT. Twenty-one healthy controls were included. Structural magnetic resonance imaging data were acquired before and after ECT. Healthy participants were scanned once. Source-based morphometry was used to investigate modulation of structural networks pre/post ECT. ECT had an impact on distinct structural networks in MDD and SZ. In both MDD and SZ SBM revealed a medial temporal lobe (MTL) network (including hippocampus and parahippocampal cortex) which showed a significant increase after ECT. The increase in MTL network strength was not associated with clinical improvement in either MDD or SZ. In SZ a lateral prefrontal/cingulate cortical network showed a volume increase after ECT, and this effect was accompanied by clinical improvement. These findings provide preliminary evidence for structural network change in response to ECT in MDD and SZ. The data suggest both diagnosis-specific and transdiagnostic ECT-effects on brain volume. In contrast to SZ, in MDD structural network modulation by ECT was not associated with clinical improvement.
authors.affiliation: Center for Psychosocial Medicine, Department of Psychiatry, University of Heidelberg, 69115 Heidelberg, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Saarland University, Kirrberger Str. 1, 66421 Homburg, Germany. Electronic address: christian.wolf@uks.eu.
authors.forename: Robert Christian
authors.initials: RC
authors.lastname: Wolf
authors.affiliation: Center for Psychosocial Medicine, Department of Psychiatry, University of Heidelberg, 69115 Heidelberg, Germany.
authors.forename: Henrike Maria
authors.initials: HM
authors.lastname: Nolte
authors.affiliation: Center for Psychosocial Medicine, Department of Psychiatry, University of Heidelberg, 69115 Heidelberg, Germany.
authors.forename: Dusan
authors.initials: D
authors.lastname: Hirjak
authors.affiliation: Department of Anesthesiology, University of Heidelberg, 69120 Heidelberg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hofer
authors.affiliation: Center for Mental Health, Klinikum Stuttgart, 70374 Stuttgart, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Seidl
authors.affiliation: Center for Psychosocial Medicine, Department of Psychiatry, University of Heidelberg, 69115 Heidelberg, Germany.
authors.forename: Malte Sebastian
authors.initials: MS
authors.lastname: Depping
authors.affiliation: Department of Radiology, University Hospital Basel, 4031 Basel, Switzerland.
authors.forename: Bram
authors.initials: B
authors.lastname: Stieltjes
authors.affiliation: Medical Image Computing Group, Division of Medical and Biological Informatics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Maier-Hein
authors.affiliation: Department of Experimental and Clinical Medical Sciences (DISM), University of Udine, Udine, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Sambataro
authors.affiliation: Center for Psychosocial Medicine, Department of Psychiatry, University of Heidelberg, 69115 Heidelberg, Germany.
authors.forename: Philipp Arthur
authors.initials: PA
authors.lastname: Thomann
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D003865:Major Depressive Disorder / Q000000981:diagnostic imaging* / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000000981:diagnostic imaging; D009473:Neuronal Plasticity; D009929:Organ Size; D012559:Schizophrenia / Q000000981:diagnostic imaging* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Depression; ECT; Electroconvulsive therapy; Prefrontal cortex; Schizophrenia; Source-based morphometry