Shape and volume changes of the superior lateral ventricle after electroconvulsive therapy measured with ultra-high field MRI

Jasper O Nuninga,René C.W Mandl,Jeroen Siero,Wendy Nieuwdorp,Sophie M Heringa,Marco P Boks,Metten Somers,Iris E.C Sommer

doi:10.1016/j.pscychresns.2021.111384

Jasper O Nuninga, René C.W Mandl + Show 6 more

Open Access

https://doi.org/10.1016/j.pscychresns.2021.111384

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Abstract

The subventricular zone (SVZ) of the lateral ventricles harbors neuronal stem cells in adult mammals. Rodent studies report neurogenic effects in the SVZ of electroconvulsive stimulation. We hypothesize that if this finding translates to depressed patients undergoing electroconvulsive therapy (ECT), this would be reflected in shape changes at the SVZ.Using T1-weighted MR images acquired at ultra-high field strength (7T), the shape and volume of the ventricles were compared from pre to post ECT after 10 ECT sessions (in patients twice weekly) or 5 weeks apart (controls) using linear mixed models with age and gender as covariates.Ventricle shape significantly changed and volume significantly decreased over time in patients for the left ventricle, but not in controls. The decrease in volume of the ventricles was associated to a decrease in depression scores, and an increase in the left dentate gyrus,However, the shape changes of the ventricles were not restricted to the neurogenic niche in the lateral walls of the ventricles, providing no clear evidence for neurogenesis as sole explanation of volume changes in the ventricles after ECT.

Highlights

Depression is a highly prevalent psychiatric disorder (Kessler et al, 2005, 2003), posing substantial burden on patients’ daily lives and their relatives (Saarni et al, 2007; Vos et al, 2012; Whiteford et al, 2013)
We investigated the effects of electroconvulsive therapy (ECT) on the volume and shape of the lateral ventricles
It has been robustly shown that electro convulsive seizures (ECS) stimulate neurogenesis (Ito et al, 2010; Madsen et al, 2000; Nakamura et al, 2013; Perera et al, 2007), and other neuroplastic processes such as synaptogenesis, angiogenesis and mossy fiber sprouting (Chen et al, 2009; Ekstrand et al, 2008; Gombos et al, 1999; Hellsten et al, 2005)

Summary

Introduction

Depression is a highly prevalent psychiatric disorder (Kessler et al, 2005, 2003), posing substantial burden on patients’ daily lives and their relatives (Saarni et al, 2007; Vos et al, 2012; Whiteford et al, 2013). In recent years substantial progress has been made in uncovering the effects of ECT on the brain, indicating widespread volumetric changes on MRI after ECT (Gbyl and Videbech, 2018; Nuninga et al, 2019; Ousdal et al, 2020a). Whether these changes are necessary or related to the an tidepressant response of ECT remains subject of debate (Nuninga et al, 2020b, 2020c; Ousdal et al, 2020a, 2020b; Takamiya et al, 2019a). We explore changes in the volume and shape of the ventricles and hypothesize that if neurogenesis takes place in the SVZ, this would be reflected in a change in the shape of the lateral walls of the ventricle; the location of the SVZ

Sample

Treatment procedure

Scanning procedure and data analysis

Ventricle volume

Shape analysis

Discussion