Effects of electroconvulsive therapy on hippocampal longitudinal axis and its association with cognitive side effects
Ousdal, Olga Therese (University of Bergen)
Argyelan, Miklos (The Zucker Hillside Hospital)
Laroy, Maarten (Leuven Brain Institute)
Anand, Amit (Brigham and Women's Hospital (Boston, Estats Units d'Amèrica))
Bouckaert, Filip (University Psychiatric Center KU Leuven (Leuven, Bèlgica))
Camprodon, Joan Albert (Massachusetts General Hospital (Boston))
Cano, Marta (Massachusetts General Hospital (Boston))
Cardoner, Narcís (Universitat Autònoma de Barcelona. Departament de Psiquiatria i de Medicina Legal)
Dannlowski, Udo (University of Muenster)
Dols, Annemiek (University Medical Center Utrecht)
Emsell, Louise (Leuven Brain Institute)
Espinoza, Randall (University of California)
Hebbrecht, Kaat (University Psychiatric Center KU Leuven (Leuven, Bèlgica))
Hurlemann, René (Carl von Ossietzky University of Oldenburg)
Jorgensen, Martin Balslev (University of Copenhagen)
Kiebs, Maximillian (University Hospital Bonn (Bonn, Alemanya))
Kishimoto, Taishiro (Keio University School of Medicine)
Narr, Katherine L. (University of California Los Angeles)
Nordanskog, Pia (Linköping University)
Opel, Nils (University of Muenster)
Redlich, Ronny (University of Halle)
Rhebergen, Didi (Amsterdam Public Health Research Institute (Països Baixos))
Sartorius, Alexander (University of Heidelberg)
Schrijvers, Didier (University Psychiatric Hospital Duffel, Duffel, Belgium)
Sienaert, Pascal (Academic Center for ECT and Neuromodulation (AcCENT) University Psychiatric Center)
Soriano-Mas, Carles (Institut d'Investigació Biomèdica de Bellvitge)
Takamiya, Akihiro (Keio University School of Medicine)
ten Doesschate, Freek (Rijnstate Hospital Arnhem)
Tendolkar, Indira (Radboud University Nijmegen)
Urretavizcaya, Mikel (Institut d'Investigació Biomèdica de Bellvitge)
van Diermen, Linda (Psychiatric Hospital Bethanië, Zoersel, Belgium)
van Eijndhoven, Philip (Radboud University Nijmegen)
van Wingen, Guido (Amsterdam Universitair Medische Centra (Amsterdam, Països Baixos). Amsterdam Neuroscience)
van Waarde, Jeroen A. (Rijnstate Hospital Arnhem)
Vandenbulcke, Mathieu (University Psychiatric Center KU Leuven (Leuven, Bèlgica))
Verdijk, Joey (Rijnstate Hospital Arnhem)
Wade, Benjamin (Massachusetts General Hospital (Boston))
Antoine, Yrondi (Université de Toulouse)
Brekke, Njål (Haukeland University Hospital (Bergen, Noruega))
Prudic, Joan (Colombia School of Medicine. Department of Psychiatry)
McClintock, Shawn (UT Southwestern Medical Center. Division of Psychology)
Kessler, Ute (Haukeland University Hospital (Bergen, Noruega))
Bartsch, Hauke (University of Bergen)
Odegaard, Ketil (Haukeland University Hospital (Bergen, Noruega))
Haavik, Jan (Haukeland University Hospital (Bergen, Noruega))
Hammar, Åsa (Skåne University Hospital (Suècia))
Abbott, Christopher (University of New Mexico)
Oltedal, Leif (University of Bergen)

Data:	2025
Resum:	Electroconvulsive therapy (ECT)-mediated hippocampal volumetric increase is consistently reported, though its clinical relevance remains debated. This study evaluates if ECT-related cognitive side effects are associated with regional volumetric changes along the hippocampal longitudinal axis. Longitudinal T1-weighted MRI scans in 435 patients (54. 0 ± 15. 0 years, 261 female) with major depression from the Global ECT-MRI Research Collaboration (GEMRIC) were used to measure changes in right global and longitudinal axis hippocampal subdivisions (head, body, tail) from baseline to post-treatment. Cognitive side effects were evaluated using pre-to-post treatment changes in two different verbal fluency tests available for 124 patients. Electric field modelling was applied to explore whether the regional hippocampal electric field strength related to individual changes in cognitive performance. Global hippocampal enlargement is observed pre-to-post ECT (p < 0. 001), but enlargement of the hippocampal head significantly exceeds the volumetric change in the hippocampal body and tail (p < 0. 001). Volumetric expansion of the hippocampal body and tail significantly associates with reduced verbal fluency scores (p < 0. 05). Moreover, volumetric reduction of the hippocampal tail at 6 months post-ECT associates with improved cognitive performance (p < 0. 05, N = 24). Finally, patients performing worse on verbal fluency tests following treatment have greater electric field during ECT in the right hippocampal body (p < 0. 05). The findings support that cognitive performance following ECT relates to macrostructural changes in the posterior cognitive hippocampus. Thus, there may be a threshold of ECT induced posterior hippocampal volumetric change, beyond which cognitive side effects occur. Electroconvulsive Therapy (ECT) is a procedure that sends small electric currents through the brain and remains the most effective acute treatment for severe depressive episodes. However, we still do not fully understand how ECT works. Studies using brain scans (MRI) before and after ECT have shown that a part of the brain called the hippocampus often becomes larger after treatment. However, the clinical relevance of the volumetric change remains unknown. In this study, we looked at whether the increase in hippocampus size is linked to cognitive side effects. We found that a larger hippocampal volumetric increase after ECT was associated with reduced performance in verbal fluency tests, which measures our ability to rapidly produce words. These results suggest that big changes in the hippocampus after ECT may be related to short-term cognitive side effects. Ousdal et al. investigate whether global or regional hippocampal volume increase after Electroconvulsive therapy (ECT) for major depressive episodes relate to cognitive side effects. Their findings suggest that pronounced structural change in the posterior hippocampus (i. e. , body and tail) associates with reduced cognitive performance following ECT.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Communications Medicine, Vol. 5, Num. 1 (October 2025) , art. 409, ISSN 2730-664X

DOI: 10.1038/s43856-025-01120-1
PMID: 41034627

9 p, 8.2 MB

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