Biophysical mechanisms of electroconvulsive therapy-induced volume expansion in the medial temporal lobe: A longitudinal in vivo human imaging study

Brain Stimulation

Maarten Laroy¹  Stefan Sunaert²  Ahmed Radwan³  Filip Bouckaert³  Wim Van Paesschen⁴  Myles Mc Laughlin⁵  Zhi-De Deng⁶  Akihiro Takamiya⁷  Louise Emsell⁷  Jeroen Blommaert⁷  Ahmad Khatoun⁷  Mathieu Vandenbulcke⁸  Pascal Sienaert⁹  François-Laurent De Winter⁹  Jan Van den Stock^1,10 

[1] Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan;Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA;Geriatric Psychiatry, University Psychiatric Center KU Leuven, Belgium;Pathology, Translational MRI, Leuven, Belgium;;KU Leuven, Department of Imaging &KU Leuven, Department of Oncology, Gynaecological Oncology, Leuven, Belgium;KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry, Leuven, Belgium;KU Leuven, Leuven Brain Institute, Department of Neurosciences, Research Group Experimental Neurology, Leuven, Belgium;KU Leuven, Leuven Brain Institute, Department of Neurosciences, Research Group Experimental Oto-rhino-laryngology, Leuven, Belgium;Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA;

关键词: Electroconvulsive therapy;    Medial temporal lobe;    Morphometry analysis;    Electric field;    Seizure;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Electroconvulsive therapy (ECT) applies electric currents to the brain to induce seizures for therapeutic purposes. ECT increases gray matter (GM) volume, predominantly in the medial temporal lobe (MTL). The contribution of induced seizures to this volume change remains unclear. Methods: T1-weighted structural MRI was acquired from thirty patients with late-life depression (mean age 72.5 ± 7.9 years, 19 female), before and one week after one course of right unilateral ECT. Whole brain voxel-/deformation-/surface-based morphometry analyses were conducted to identify tissue-specific (GM, white matter: WM), and cerebrospinal fluid (CSF) and cerebral morphometry changes following ECT. Whole-brain voxel-wise electric field (EF) strength was estimated to investigate the association of EF distribution and regional brain volume change. The association between percentage volume change in the right MTL and ECT-related parameters (seizure duration, EF, and number of ECT sessions) was investigated using multiple regression. Results: ECT induced widespread GM volume expansion with corresponding contraction in adjacent CSF compartments, and limited WM change. The regional EF was strongly correlated with the distance from the electrodes, but not with regional volume change. The largest volume expansion was identified in the right MTL, and this was correlated with the total seizure duration. Conclusions: Right unilateral ECT induces widespread, bilateral regional volume expansion and contraction, with the largest change in the right MTL. This dynamic volume change cannot be explained by the effect of electrical stimulation alone and is related to the cumulative effect of ECT-induced seizures.

【 授权许可】

Unknown