Changes in White Matter Microstructure After Electroconvulsive Therapy for Treatment-Resistant Depression.
Gregor Gryglewski1, René Seiger1, Pia Baldinger-Melich1
1Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
The International Journal of Neuropsychopharmacology
|November 20, 2019
Summary
Electroconvulsive therapy (ECT) may alter white matter microstructure in treatment-resistant depression. This study observed changes in axial diffusivity, particularly in the right hemisphere after right unilateral ECT, but found no direct link to patient response.
Area of Science:
- Neuroscience
- Psychiatry
- Radiology
Background:
- Treatment-resistant depression (TRD) is a severe psychiatric condition.
- Altered white matter microstructure is linked to poor antidepressant response.
- Electroconvulsive therapy (ECT) is effective for TRD, but its impact on white matter is unclear.
Purpose of the Study:
- To investigate the effects of right unilateral ECT on white matter microstructure in patients with TRD.
- To explore potential correlations between these microstructural changes and clinical outcomes.
Main Methods:
- 13 patients with severe unipolar TRD underwent diffusion tensor imaging (DTI) before and after a series of right unilateral ECT.
- Voxel-wise comparison of diffusivity metrics using tract-based spatial statistics and repeated-measures ANOVA.
Main Results:
- 12 patients responded to ECT, with 9 achieving remission.
- Increased axial diffusivity was found in the right hemisphere's posterior internal capsule (PFWE ≤ .05).
- This increase was significantly greater in the right hemisphere compared to the left (P < .05), but not correlated with treatment response.
Conclusions:
- ECT appears to affect white matter diffusivity metrics, with effects lateralized to the hemisphere of electrode placement.
- Further controlled studies are needed to clarify the relationship between ECT-induced microstructural changes, electrode placement, and clinical outcomes.
