Year: 2023
Type: article
Abstract: Symposium title: Neuroimaging- and clinical findings from the global ECT-MRI Collaboration (GEMRIC): what have we learned and where to go from here? Symposium description: The Global ECT-MRI Collaboration (GEMRIC) provides a large longitudinal database of neuroimaging data and clinical/cognitive records from patients undergoing ECT. Over the past months, various research groups have investigated the effects of ECT on brain structure, function, cognitive side effects, clinical response, electrical field modeling, and other topics. In this symposium, Maximilian Kiebs (University Medical Center Bonn), Miklos Argyelan (Feinstein Institute for Medical Research, Northwell Health), Laurens van de Mortel (Amsterdam University Medical Center) and Joey Verdijk (Rijnstate Medical Centre) will give four updates on the most important recent GEMRIC findings. These findings include electrical field modeling for ECT and its relation to structural brain increases and clinical response (1), a lack of clear functional changes visible in the GEMRIC data with conventional analysis methods (2), an emphasis on alternative methods for investigating the functional brain impact of ECT and its implication for the disrupt-and-rewire theory of ECT (3), and a prospective on improving cognition after ECT and a proposal for a large cognitive post-ECT database (4). Abstract Background: The Global ECT MRI Collaboration (GEMRIC) is focused on identifying the underlying mechanisms for ECT’s antidepressant response and cognitive side effects. Here, we aim to determine the relationships between electric field (E-field) strength, hippocampal neuroplasticity, and clinical outcomes. We hypothesized that e-field would be related to both changes in structural volume and clinical outcomes. We performed the initial analysis with the GEMRIC subjects that received right unilateral electrode placement (RUL). We present the GEMRIC results and results from other data sets to clarify these relationships. Methods: From the GEMRIC database, RUL subjects (n = 151) that had pre-/post-ECT structural magnetic resonance imaging (sMRI) and antidepressant outcomes were included in the analysis. We assessed the relationships between regional EF strength, longitudinal volume change from 85 brain regions and antidepressant outcomes with linear regression and false discovery rate correction. From another data set, we further assessed the relationships with stimulation time (pulse width, frequency, and pulse train duration) with similar methods. Results: We demonstrated a linear relationship between right hippocampal E-field and left hippocampal (t300 =5.97, r = 0.33, p< 0.001) and amygdala (t300 = 11.35, r = 0.55, p < 0.001) volume change. We did not find a relationship with change in structural volumes and change in depression severity, nor did structural volume changes mediate a relationship between E-field and antidepressant outcomes. We provided a follow-up analysis demonstrating that stimulation time strengthened the relationship between E-field and change in structural volume (rhipp=0.40, ramy=0.60). Conclusions: E-field is related to structural volume change. Stimulation time strengthens the E-field and structural volume relationship. Selection bias, non-standardized treatment algorithms, and site differences may have confounded the relationships with clinical outcomes. Single-site studies have subsequently determined both the mediation analysis with E-field, structural volume change, and clinical outcomes. Research Category and Technology and Methods Clinical Research: 2. Electroconvulsive Therapy (ECT) Keywords: ECT, Structural Brain Imaging, Neuroplasticity, EEG
Source: Brain stimulation
Authors: Chris Abbott, Miklos Argyelan
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,830
OpenAlex ID: W4320908509