Structural Plasticity of the Hippocampus and Amygdala Induced by Electroconvulsive Therapy in Major Depression

Joshi, Shantanu H.; Espinoza, Randall T.; Pirnia, Tara; Shi, Jie; Wang, Yalin; Ayers, Brandon; Leaver, Amber; Woods, Roger P.; Narr, Katherine L.

doi:10.1016/j.biopsych.2015.02.029

Cited by 320Electroconvulsive Therapy StudiesTreatment of Major DepressionTranscranial Magnetic Stimulation Studies

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Structural Plasticity of the Hippocampus and Amygdala Induced by Electroconvulsive Therapy in Major Depression

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Joshi, Shantanu H., Espinoza, Randall T., Pirnia, Tara, Shi, Jie, Wang, Yalin, Ayers, Brandon, Leaver, Amber, Woods, Roger P., Narr, Katherine L.·2016·Biological Psychiatry

DOI 10.1016/j.biopsych.2015.02.029PMC PMC4561035

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Abstract

Background Electroconvulsive therapy (ECT) elicits a rapid and robust clinical response in patients with refractory depression. Neuroimaging measures of structural plasticity relating to and predictive of ECT response may point to the mechanisms underlying rapid antidepressant effects and establish biomarkers to inform other treatments. Here, we determine the effects of 1) diagnosis and 2) ECT on global and local variations of hippocampal and amygdalar structure in major depression and predictors of ECT-related clinical response Methods Longitudinal changes in hippocampal and amygdala structure were examined in patients with major depression (N= 43, scanned thrice; prior to ECT, after the 2nd ECT session, and within one week of completing the ECT treatment series) referred for ECT as part of their standard clinical care. Cross-sectional comparisons with demographically similar controls (N= 32, scanned twice) established effects of diagnosis. Results Patients showed smaller hippocampal volumes compared to controls at baseline (p<.04). Both hippocampal and amygdalar volumes increased with ECT (p<.001) and in relation to symptom improvement (p<.01). Hippocampal volume at baseline predicted subsequent clinical response (p<.05). Shape analysis revealed pronounced morphometric changes in the anterior hippocampus and basolateral and centromedial amygdala. All structural measures remained stable across time in controls. Conclusions ECT induced neuroplasticity in the hippocampus and amygdala relates to improved clinical response and is pronounced in regions with prominent connections to ventromedial prefrontal cortex and other limbic structures. Smaller hippocampal volumes at baseline predict a more robust clinical response. Neurotrophic processes including neurogenesis shown in preclinical studies may underlie these structural changes.

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Electroconvulsive therapy promotes structural plasticity including increased volume and morphometric changes in the hippocampus and the amygdala along with improved clinical responses, especially in patients with a smaller hippocampal volume.
“Recent clinical studies showed that electroconvulsive therapy (ECT) promoted structural plasticity including increased volume and morphometric changes in the hippocampus and the amygdala along with improved clinical responses, especially in patients with a smaller hippocampal volume (Joshi et al. 2016; Nordanskog et al. 2010; Tendulkar et al. 2013).”
From Neurotrophic factors and neuroplasticity pathways in the pathophysiology and treatment of depression (2018) · cites this paper as Joshi et al. 2016

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The anti-inflammatory role of Omega-3 polyunsaturated fatty acids metabolites in pre-clinical models of psychiatric, neurodegenerative, and neurological disorders
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Predicting individual responses to the electroconvulsive therapy with hippocampal subfield volumes in major depression disorder
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Brain Changes Induced by Electroconvulsive Therapy Are Broadly Distributed
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Electroconvulsive therapy selectively enhanced feedforward connectivity from fusiform face area to amygdala in major depressive disorder
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Inflammation and Improvement of Depression Following Electroconvulsive Therapy in Treatment-Resistant Depression
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Behavioral and structural adaptations to stress
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Relationship Between Hippocampal Volume, Serum BDNF, and Depression Severity Following Electroconvulsive Therapy in Late-Life Depression
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Electroconvulsive therapy increases temporal gray matter volume and cortical thickness
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Rapid antidepressant effect of ketamine correlates with astroglial plasticity in the hippocampus
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Morphological changes in subregions of hippocampus and amygdala in major depressive disorder patients
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Magnetic seizure therapy reduces suicidal ideation and produces neuroplasticity in treatment-resistant depression
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Subgenual cingulate cortical activity predicts the efficacy of electroconvulsive therapy
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Hippocampal Subfield Volumes in Patients With First-Episode Psychosis
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Baicalin promotes hippocampal neurogenesis via the Wnt/β-catenin pathway in a chronic unpredictable mild stress-induced mouse model of depression
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Local functional connectivity density is closely associated with the response of electroconvulsive therapy in major depressive disorder
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Fronto-Temporal Connectivity Predicts ECT Outcome in Major Depression
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Electroconvulsive therapy (ECT) for treating agitation in dementia (major neurocognitive disorder) – a promising option
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Electroconvulsive therapy in treatment resistant depression
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SMRI Biomarkers Predict Electroconvulsive Treatment Outcomes: Accuracy with Independent Data Sets
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The critical role of amygdala subnuclei in nociceptive and depressive-like behaviors in peripheral neuropathy
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Influence of APOE Genotype on Hippocampal Atrophy over Time - An N=1925 Surface-Based ADNI Study
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Altered hippocampus and amygdala subregion connectome hierarchy in major depressive disorder
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Mechanisms of Antidepressant Response to Electroconvulsive Therapy Studied With Perfusion Magnetic Resonance Imaging
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Electrical Stimulation Elicits Neural Stem Cells Activation: New Perspectives in CNS Repair
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Parsing the Network Mechanisms of Electroconvulsive Therapy
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Glutamatergic System in Depression and Its Role in Neuromodulatory Techniques Optimization
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Decreased Cognitive Functioning After Electroconvulsive Therapy Is Related to Increased Hippocampal Volume
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Bilateral ECT induces bilateral increases in regional cortical thickness
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Radix Scutellariae Attenuates CUMS-Induced Depressive-Like Behavior by Promoting Neurogenesis via cAMP/PKA Pathway
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Volumetric and shape analyses of subcortical structures in United States service members with mild traumatic brain injury
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Effects of Serial Ketamine Infusions on Corticolimbic Functional Connectivity in Major Depression
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Hippocampal volume and memory impairment after electroconvulsive therapy in patients with depression
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Desynchronization and Plasticity of Striato-frontal Connectivity in Major Depressive Disorder
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Effects of electroconvulsive therapy on amygdala function in major depression – a longitudinal functional magnetic resonance imaging study
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Brain Stimulation in Eating Disorders: State of the Art and Future Perspectives
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A century of research on neuromodulation interventions: A scientometric analysis of trends and knowledge maps
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Is tDCS a potential first line treatment for major depression?
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Bifrontal electroconvulsive therapy changed regional homogeneity and functional connectivity of left angular gyrus in major depressive disorder
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Authors: Joshi, S. H., Espinoza, R. T., Pirnia, T., Shi, J., Wang, Y., Ayers, B., Leaver, A., Woods, R. P., & Narr, K. L.
Affiliations: University of California, Los Angeles (US)
Arizona State University (US)
Corresponding author: Narr, Katherine L.
ORCID: Joshi, Shantanu H.
Espinoza, Randall T.
Pirnia, Tara
Shi, Jie
Wang, Yalin
Leaver, Amber
Woods, Roger P.
Narr, Katherine L.
Venue: Biological Psychiatry
Publisher: Elsevier BV
Published: 2016-02
Volume: 79
Issue: 4
Pages: 282-292
ISSN: 0006-3223 (ISSN-L)
DOI: 10.1016/j.biopsych.2015.02.029
PMC: PMC4561035
OpenAlex: W2030957288
Semantic Scholar: dbc2079d218eb4354800e786a0bc85e1722ca84e
Cited by: 320
References: 80
Citations by year: 2026: 16 · 2025: 18 · 2024: 29 · 2023: 22 · 2022: 23 · 2021: 38 · 2020: 28 · 2019: 43 · 2018: 37 · 2017: 32 · 2016: 25
FWCI: 27.84
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Biological Psychiatry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Institute of Mental Health (R01MH092301, K24MH102743)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Keywords: electroconvulsive therapy, major depressive disorder, hippocampus, amygdala, structural plasticity, hippocampal volume, amygdala volume, neuroimaging biomarkers, basolateral amygdala, centromedial amygdala, ventromedial prefrontal cortex, neurogenesis
MeSH terms: Adult, Amygdala, Cross-Sectional Studies, Major Depressive Disorder, Electroconvulsive Therapy, Female, Hippocampus, Humans, Male, Middle Aged, Neuronal Plasticity, Psychiatric Status Rating Scales, Treatment Outcome, Depressive Disorder, Treatment-Resistant

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Structural Plasticity of the Hippocampus and Amygdala Induced by Electroconvulsive Therapy in Major Depression

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