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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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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