This effect was particularly striking in two areas, the hippocampus and the amygdala. The patients who experienced the strongest electric fields showed the largest increase in brain volume, and individual brain areas expanded if the electric field within them exceeded a certain threshold. The scans revealed that the gray matter of the patients’ brains expanded during the treatment. In a large multinational study, 151 patients with severe depression underwent brain scans before and after a course of ECT. now show that electric fields affect the brain by making a part of the brain known as the gray matter expand. This suggests that the benefits of ECT depend on the electric field itself.Īrgyelan et al. They show that increasing the strength of the electric field alters the clinical effects of ECT, without affecting the seizure. These currents activate neurons and make them fire, causing a seizure, but it remains unclear how this reduces symptoms of depression.įor many years, researchers thought that the induced seizure must be key to the beneficial effects of ECT, but recent studies have cast doubt on this idea. During an ECT session, the patient is placed under general anesthesia and two electrodes are attached to the scalp to produce an electric field that generates currents within the brain. Many patients who do not respond to medication find that their symptoms improve after ECT. eLife digestĮlectroconvulsive therapy, or ECT for short, can be an effective treatment for severe depression. In summary, we showed that high electrical fields are strongly associated with robust volume changes in a dose-dependent fashion. However, neither structural volume changes nor electric field was associated with antidepressant response. After controlling for nuisance variables (age, treatment number, and study site), we identified two regions (left amygdala and left hippocampus) with a strong relationship between EF and volume change (FDR corrected p<0.01). The majority of regional volumes increased significantly, and volumetric changes correlated with regional electric field (t = 3.77, df = 83, r = 0.38, p=0.0003). We used electric field (EF) modeling in 151 ECT treated patients with depression to determine the regional relationships between EF, unbiased longitudinal volume change, and antidepressant response across 85 brain regions. Recent longitudinal neuroimaging studies in patients with electroconvulsive therapy (ECT) suggest local effects of electric stimulation (lateralized) occur in tandem with global seizure activity (generalized). University of New Mexico School of Medicine, United States.University of Duisburg-Essen, Germany.Donders Institute for Brain Cognition and Behavior, Centre for Cognitive Neuroimaging, Netherlands.Radboud University Medical Center, Netherlands.Center for Psychiatry and Behavioral Science, Komagino Hospital, Japan.Keio University School of Medicine, Japan.Haukeland University Hospital, University of Bergen, Norway.Amsterdam UMC, location VUmc, GGZinGeest, Old Age Psychiatry, Amsterdam Neuroscience, Netherlands.CIBERSAM, Carlos III Health Institute, Spain.Bellvitge University Hospital-IDIBELL, Spain.University of California, San Diego, United States.The City College of the City University of New York, United States.University of California, Los Angeles, United States.National Institute of Mental Health, United States. Haukeland University Hospital, Mohn Medical Imaging and Visualization Centre, Norway.Zucker School of Medicine, United States.Center for Neuroscience, Feinstein Institute for Medical Research, United States.The Zucker Hillside Hospital, United States.
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