Commonalities and differences in ECT-induced gray matter volume change between depression and schizophrenia

• Published in: NeuroImage clinical 2023-01, Vol.38, p.103429-103429, Article 103429
• Main Authors: Kawashima, Hirotsugu, Yamasaki, Shimpei, Kubota, Manabu, Hazama, Masaaki, Fushimi, Yasutaka, Miyata, Jun, Murai, Toshiya, Suwa, Taro
• Format: Article
• Language: English
• Subjects: Brain; Depression; Depressive Disorder, Major - diagnostic imaging; Depressive Disorder, Major - pathology; Depressive Disorder, Major - therapy; Electroconvulsive therapy; Electroconvulsive Therapy - methods; Gray Matter - pathology; Humans; Magnetic Resonance Imaging; Major depressive disorder; Regular; Schizophrenia; Schizophrenia - diagnostic imaging; Schizophrenia - pathology; Schizophrenia - therapy; Voxel-based morphometry
• ISSN: 2213-1582; 2213-1582
• DOI: 10.1016/j.nicl.2023.103429

•Volume change after ECT can be either diagnosis-specific or transdiagnostic.•Comparing two diagnostic groups may provide clues to distinguish them.•Common increase in regions including the limbic system may be trandiagnostic.•Pregenual anterior cingulate cortex shows schizophrenia-specific volume increase.•Volume increase in this region correlates with clinical improvement. Electroconvulsive therapy (ECT) is one of the most effective treatments for depression and schizophrenia, particularly in urgent or treatment-resistant cases. After ECT, regional gray matter volume (GMV) increases have been repeatedly reported both in depression and schizophrenia. However, the interpretation of these findings remains entangled because GMV changes do not necessarily correlate with treatment effects and may be influenced by the intervention itself. We hypothesized that the comparison of longitudinal magnetic resonance imaging data between the two diagnostic groups will provide clues to distinguish diagnosis-specific and transdiagnostic changes. Twenty-nine Japanese participants, including 18 inpatients with major depressive disorder and 11 with schizophrenia, underwent longitudinal voxel-based morphometry before and after ECT. We investigated GMV changes common to both diagnostic groups and those specific to each group. Moreover, we also evaluated potential associations between GMV changes and clinical improvement for each group. In both diagnostic groups, GMV increased in widespread areas after ECT, sharing common regions including: anterior temporal cortex; medial frontal and anterior cingulate cortex; insula; and caudate nucleus. In addition, we found a schizophrenia-specific GMV increase in a region including the left pregenual anterior cingulate cortex, with volume increase significantly correlating with clinical improvement. Transdiagnostic volume changes may represent the effects of the intervention itself and pathophysiological changes common to both groups. Conversely, diagnosis-specific volume changes are associated with treatment effects and may represent pathophysiology-specific impacts of ECT.