Volume of the Human Hippocampus and Clinical Response Following Electroconvulsive Therapy.
Volume of the Human Hippocampus and Clinical Response Following Electroconvulsive Therapy.
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DOI：
10.1016/j.biopsych.2018.05.017
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发表时间：
2018-10-15
影响因子：
10.6
通讯作者：
Dale AM
中科院分区：
文献类型：
--
作者：
Oltedal L;Narr KL;Abbott C;Anand A;Argyelan M;Bartsch H;Dannlowski U;Dols A;van Eijndhoven P;Emsell L;Erchinger VJ;Espinoza R;Hahn T;Hanson LG;Hellemann G;Jorgensen MB;Kessler U;Oudega ML;Paulson OB;Redlich R;Sienaert P;Stek ML;Tendolkar I;Vandenbulcke M;Oedegaard KJ;Dale AM
电休克治疗 (ECT) 后常报告海马增大。为了阐明机制，我们检查了 ECT 引起的海马体积变化是否与剂量（ECT 次数和电极放置次数）相关，并作为临床结果的生物标志物。获得了参与全球 ECT-MRI 研究合作的 10 个独立中心的纵向神经影像和临床数据，以进行大型分析。海马体积是从结构 MR 图像中提取的，这些图像是在经历重度抑郁发作的患者 (N = 281) 使用右侧单侧 (RUL) 和双侧 (BL) 刺激完成 ECT 治疗系列之前和之后获得的。未治疗的非抑郁对照（N=95）被扫描两次。每个 ECT 疗程海马体积变化的线性分量为 0.28%，0.08 SE，p<0.001。体积变化因左侧海马电极放置位置而异（BL：3.3 ± 2.2%，d=1.5；RUL：1.6 ± 2.1%，d=0.8；p<0.0001），但右侧海马体则不然（BL：3.0 ± 1.7%，d=1.8；RUL：2.7 ± 2.0%，d=1.4；RUL：2.7 ± 2.0%，d=1.4； p=0.36,)。每个 ECT 疗程的导联放置量变化因半球而异。治疗相关体积增加较大的个体结局较差（体积每增加 1%，MADRS 变化 -1.0, 0.35 SE，p=0.005），尽管在控制 ECT 数量后效果并不显着（斜率：-0.69, 0.38 SE，p = 0.069）。 ECT 次数和导线放置会影响海马增大的程度和偏侧性，但体积变化与临床结果并不呈正相关。结果表明，ECT 的高疗效不能用海马体增大来解释，海马体增大本身可能无法作为治疗结果的可行生物标志物。
Hippocampal enlargements are commonly reported following electroconvulsive therapy (ECT). To clarify mechanisms, we examined if ECT-induced hippocampal volume change relates to dose (number of ECT sessions and electrode placement) and acts as a biomarker of clinical outcome. Longitudinal neuroimaging and clinical data from ten independent sites participating in the Global ECT-MRI Research Collaboration were obtained for mega-analysis. Hippocampal volumes were extracted from structural MR images, acquired before and after patients (N=281) experiencing a major depressive episode completed an ECT treatment series using right unilateral (RUL) and bilateral (BL) stimulation. Untreated non-depressed controls (N=95) were scanned twice. The linear component of hippocampal volume change was 0.28%, 0.08 SE, per ECT session, p<0.001. Volume change varied by electrode placement in the left (BL: 3.3 ± 2.2%, d=1.5; RUL: 1.6 ± 2.1%, d=0.8; p<0.0001), but not the right hippocampus (BL: 3.0 ± 1.7%, d=1.8; RUL: 2.7 ± 2.0%, d=1.4; p=0.36,). Volume change for lead placement per ECT session varied similarly by hemisphere. Individuals with greater treatment-related volume increases had poorer outcomes (MADRS change −1.0, 0.35 SE, per 1% volume increase, p=0.005), although effects were not significant after controlling for ECT number (slope: −0.69, 0.38 SE, p = 0.069). The number of ECT sessions and lead placement impacts the extent and laterality of hippocampal enlargement, but volume change is not positively associated with clinical outcome. Results suggest the high efficacy of ECT is not explained by hippocampal enlargement, which alone, might not serve as a viable biomarker for treatment outcome.
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影响因子：
6.6
作者：
Fluitman, Sjoerd B. A. H. A.;Heijnen, Cobi J.;Westenberg, Herman G. M.
通讯作者：
Westenberg, Herman G. M.
影响因子：
82.9
作者：
Eriksson, PS;Perfilieva, E;Gage, FH
通讯作者：
Gage, FH
影响因子：
82.9
作者：
Drysdale AT;Grosenick L;Downar J;Dunlop K;Mansouri F;Meng Y;Fetcho RN;Zebley B;Oathes DJ;Etkin A;Schatzberg AF;Sudheimer K;Keller J;Mayberg HS;Gunning FM;Alexopoulos GS;Fox MD;Pascual-Leone A;Voss HU;Casey BJ;Dubin MJ;Liston C
通讯作者：
Liston C
DOI：
10.1001/jama.2017.3826
发表时间：
2017-04-18
期刊：
JAMA
影响因子：
--
作者：
Friedrich, M J
通讯作者：
Friedrich, M J
影响因子：
5.3
作者：
Haq, Aazaz U.;Sitzmann, Adam F.;Mickey, Brian J.
通讯作者：
Mickey, Brian J.