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White matter changes following electroconvulsive therapy for depression: a multicenter ComBat harmonization approach.
Jean-Baptiste Belge1,2, Peter C R Mulders3,4, Linda Van Diermen5,6
1Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, S.033, Universiteitsplein 1, 2610, Wilrijk, Belgium. jeanbaptiste.belge@uantwerpen.be.
Electroconvulsive therapy (ECT) positively impacts white matter (WM) microstructure, particularly in brain circuits involved in depression. Responders to ECT may have reduced baseline WM integrity, suggesting heightened sensitivity to its neuroplastic effects.
Area of Science:
- Neuroimaging
- Neuroscience
- Psychiatry
Background:
- Electroconvulsive therapy (ECT) is a potent treatment for severe depression.
- Previous studies on ECT's effects on white matter (WM) microstructure using diffusion metrics have yielded inconsistent results due to limited statistical power.
- Multicenter data harmonization is crucial for robust analysis of neuroimaging findings.
Purpose of the Study:
- To investigate whether changes in white matter (WM) microstructure occur following electroconvulsive therapy (ECT).
- To identify specific diffusion tensor imaging (DTI) metrics and brain regions affected by ECT.
- To explore baseline WM differences between ECT responders and non-responders.
Main Methods:
- Harmonization of Diffusion Tensor Imaging (DTI) data from 58 participants across 4 sites using ComBat.
- Application of whole-brain, tract-based spatial statistics (TBSS) to analyze changes in Fractional Anisotropy (FA), Mean Diffusivity (MD), Radial Diffusivity (RD), and Axial Diffusivity (AD).
- Comparison of baseline WM integrity (FA, AD) between responders and non-responders.
Main Results:
- ECT increased FA in the right splenium of the corpus callosum and left cortico-spinal tract.
- ECT increased AD in the left superior longitudinal fasciculus and right inferior fronto-occipital fasciculus.
- Increased MD and RD were observed in bilateral white matter structures; responders had lower baseline FA and AD in specific tracts.
Conclusions:
- ECT modulates WM microstructure in brain circuits relevant to depression pathophysiology.
- Harmonized multicenter DTI data enhance the power to detect ECT-induced microstructural changes.
- Baseline WM integrity differences may identify patients more sensitive to ECT's neuroplastic effects, suggesting a distinct subtype.
