Accuracy of deep brain stimulation electrodes implanted by frameless system -Nexframe©

Abstract

s / Brain Stimulation 8 (2015) 412e427 425 l Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia m Stony Brook University, Stony Brook, NY n Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX Introduction: There are reports of increases in hippocampal volume after ECT, but the relevance of this finding to antidepressant effects of ECT is uncertain. This study used a novel magnetic resonance spectroscopy (MRS) method to assess for evidence of ECT-induced neurogenesis, and examined the relationship of MRS changes to hippocampal volume change and antidepressant outcomes at the end of the ECT course. Methods: 20 depressed patients (9 female; mean age 53.9 years, range 33-79 years) treated with a course of ECT (N1⁄48 right unilateral, N1⁄412 bilateral) underwent MRS (1.28ppm signal) and structural MRI imaging prior to ECT, after 1-3 ECT, and at end of the ECT course. Mood was rated using MADRS score at the same time points. Results: ECT treatment was associated with significant improvement in mood (70% reduction in mean MADRS score, 71% response rate, 53% remission rate) and increase in hippocampal volume. Increase in the 1.28ppm MRS signal early in the ECT course was correlated with lower end-of-treatment MADRS scores (r1⁄4-0.57, p1⁄40.034) and with hippocampal volume expansion (r1⁄40.73, p1⁄40.003). This increased hippocampal volume was also correlated with lower MADRS scores (r1⁄4-0.64, p1⁄40.008). Conclusions: This is the first study in humans to suggest hippocampal neurogenesis may be linked to the antidepressant efficacy of ECT.