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Clinical Relevance of Brain Changes After Electroconvulsive Therapy: Is There Really No Link at All?

  • Jasper O. Nuninga
    Correspondence
    Address correspondence to Jasper O. Nuninga, M.Sc.
    Affiliations
    Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands

    Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
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  • René C.W. Mandl
    Affiliations
    Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
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  • Iris E.C. Sommer
    Affiliations
    Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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      Recently, Ousdal et al. (
      • Ousdal O.T.
      • Argyelan M.
      • Narr K.L.
      • Abbott C.
      • Wade B.
      • Vandenbulcke M.
      • et al.
      Brain changes induced by electroconvulsive therapy are broadly distributed.
      ) reported widespread changes in cortical and subcortical volumes after electroconvulsive therapy (ECT). They reported that although the number of ECT sessions is associated with changes in multiple volumes in the brain, clinical response is not. While their analyses are sound and open up new research avenues, and their dataset is adequately powered, an important question remains.
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      Linked Article

      • Brain Changes Induced by Electroconvulsive Therapy Are Broadly Distributed
        Biological PsychiatryVol. 87Issue 5
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          Electroconvulsive therapy (ECT) is associated with volumetric enlargements of corticolimbic brain regions. However, the pattern of whole-brain structural alterations following ECT remains unresolved. Here, we examined the longitudinal effects of ECT on global and local variations in gray matter, white matter, and ventricle volumes in patients with major depressive disorder as well as predictors of ECT-related clinical response.
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      • Reply to: Clinical Relevance of Brain Changes After Electroconvulsive Therapy: Is There Really No Link at All?
        Biological PsychiatryVol. 89Issue 4
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          In our recent publication (1), we reported widespread gray matter volumetric increases following electroconvulsive therapy (ECT) in a sample of 328 depressed patients from 14 independent sites. The volumetric increases encompassed 79 of 84 cortical and subcortical gray matter regions of interest (ROIs), including the hippocampus, and were paralleled by a significant decrease in total ventricle volume. However, the volumetric changes of the gray matter ROIs were not significantly associated with changes in depression scores in a general linear model (GLM).
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