ECT-induced cognitive side effects are associated with hippocampal enlargement.
ECT-induced cognitive side effects are associated with hippocampal enlargement.
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ECT诱导的认知副作用与海马增大有关。
DOI：
10.1038/s41398-021-01641-y
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发表时间：
2021-10-08
影响因子：
6.8
通讯作者：
Malhotra AK
中科院分区：
文献类型：
--
作者：
Argyelan M;Lencz T;Kang S;Ali S;Masi PJ;Moyett E;Joanlanne A;Watson P;Sanghani S;Petrides G;Malhotra AK
电休克疗法（ECT）是治疗难治性抑郁症最有效的治疗方法，但它未得到充分利用，部分原因是它在相当数量的患者中引起认知副作用的声誉。尽管在过去的二十年里对ECT进行了深入的神经影像学研究，但认知副作用的潜在神经生物学相关性仍然难以捉摸。由于主要的ECT相关的认知缺陷是记忆障碍，它已经表明，海马可能发挥了至关重要的作用。在本研究中，我们在两个独立的队列（N = 15/14）中对29名受试者进行了纵向MRI和详细的神经心理学测试，以测试体积变化是否与认知副作用相关。这两个队列接受的ECT研究方案略有不同，反映在电极放置和治疗次数上。我们使用纵向freesurfer算法（6.0）来获得海马体积变化的无偏差估计，并测试其与神经认知评分变化的关系。作为一项探索性分析，为了评估海马体的影响有多具体，我们还计算了其他41个区域的这种关系。此外，我们还分析了一组健康志愿者（N = 29）的认知数据，以评估实践效果。我们的研究结果支持了海马扩大与认知结果恶化相关的假设，并且该结果在具有不同诊断、不同电极放置和不同ECT会话次数的两个独立队列中是可推广的。我们发现，在两个队列中，治疗显著增加了海马体的体积大小（队列1：t = 5.07，队列2：t = 4.82; p < 0.001），并且体积增加与神经认知T评分变化相关。（队列1：r =-0.68，p = 0.005;队列2：r =-0.58，p = 0.04）。总的来说，我们的研究表明，避免海马体积增加的新治疗方法可能会产生更好的副作用。
Electroconvulsive therapy (ECT) is of the most effective treatments available for treatment-resistant depression, yet it is underutilized in part due to its reputation of causing cognitive side effects in a significant number of patients. Despite intensive neuroimaging research on ECT in the past two decades, the underlying neurobiological correlates of cognitive side effects remain elusive. Because the primary ECT-related cognitive deficit is memory impairment, it has been suggested that the hippocampus may play a crucial role. In the current study, we investigated 29 subjects with longitudinal MRI and detailed neuropsychological testing in two independent cohorts (N = 15/14) to test if volume changes were associated with cognitive side effects. The two cohorts underwent somewhat different ECT study protocols reflected in electrode placements and the number of treatments. We used longitudinal freesurfer algorithms (6.0) to obtain a bias-free estimate of volume changes in the hippocampus and tested its relationship with neurocognitive score changes. As an exploratory analysis and to evaluate how specific the effects were to the hippocampus, we also calculated this relationship in 41 other areas. In addition, we also analyzed cognitive data from a group of healthy volunteers (N = 29) to assess practice effects. Our results supported the hypothesis that hippocampus enlargement was associated with worse cognitive outcomes, and this result was generalizable across two independent cohorts with different diagnoses, different electrode placements, and a different number of ECT sessions. We found, in both cohorts, that treatment robustly increased the volume size of the hippocampus (Cohort 1: t = 5.07, Cohort 2: t = 4.82; p < 0.001), and the volume increase correlated with the neurocognitive T-score change. (Cohort 1: r = −0.68, p = 0.005; Cohort 2: r = −0.58; p = 0.04). Overall, our research indicates that novel treatment methods serving to avoid hippocampal volume increase may result in a better side effect profile.
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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.
DOI：
10.1159/000497376
发表时间：
2019-04-01
期刊：
Molecular neuropsychiatry
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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作者：
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DOI：
10.1073/pnas.1321399111
发表时间：
2014-01-21
影响因子：
11.1
作者：
Dukart, Juergen;Regen, Francesca;Draganski, Bogdan
通讯作者：
Draganski, Bogdan