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Longitudinal Changes in Superficial White Matter Microstructure After ECT in MDD

Poster No:

492

Submission Type:

Abstract Submission

Authors:

Liangda Zhong¹^,2, Sha Liu¹^,2, Jing Wu¹^,2, Zhiang Su¹^,2, Xinhu Yang¹^,2, Wei Zheng¹^,2, Huawang Wu¹^,2

Institutions:

¹The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China, Guangzhou, Guangdong Province, ²Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China, Guangzhou, China

First Author:

Liangda Zhong
The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China|Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
Guangzhou, Guangdong Province|Guangzhou, China

Co-Author(s):

Sha Liu
The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China|Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
Guangzhou, Guangdong Province|Guangzhou, China

Jing Wu
The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China|Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
Guangzhou, Guangdong Province|Guangzhou, China

Zhiang Su
The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China|Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
Guangzhou, Guangdong Province|Guangzhou, China

Xinhu Yang
The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China|Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
Guangzhou, Guangdong Province|Guangzhou, China

Wei Zheng
The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China|Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
Guangzhou, Guangdong Province|Guangzhou, China

Huawang Wu
The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China|Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
Guangzhou, Guangdong Province|Guangzhou, China

Introduction:

Electroconvulsive therapy (ECT) is a safe and rapidly effective treatment for severe forms of major depressive disorder (MDD), particularly in patients at high risk for suicidal behavior (Ottosson & Odeberg, 2012). While many studies have demonstrated that ECT affects the integrity of deep white matter in MDD (Gryglewski et al., 2020; Ousdal et al., 2022; Repple et al., 2020), few have investigated the microstructural properties of superficial white matter (SWM) in relation to ECT. Our study aims to explore SWM changes induced by ECT using free water imaging and neurite orientation dispersion and density imaging (NODDI).

Methods:

We collected longitudinal multi-shell diffusion tensor imaging datasets from 16 patients both before and after ECT. Individual measurements of neurite orientation dispersion and density imaging (NODDI) metrics and free-water corrected axial diffusivity (fweAD) were estimated. Using a probabilistic tractography approach, we constructed a sample-specific superficial white matter (SWM) mask and conducted a SWM-based tract-based spatial statistics (TBSS) analysis to identify SWM tracts with statistically significant pairwise differences. Voxel-wise results were corrected using threshold-free cluster enhancement and family-wise error rate correction (p < 0.05) and were subsequently reported with reference to the SWM atlas (Guevara et al., 2017).

Results:

Compared to their before-ECT state, MDD patients having ECT exhibited a significant decrease in NODDI values (Fig. 1a) within a cluster encompassing bundles connecting the right pars orbitalis to the insula (Or-Ins) and the right lateral orbitofrontal cortex to the rostral middle frontal cortex (LOF-RMF). In contrast, a significant increase in fweAD values was observed in five clusters (Fig. 1b): bundles connecting the right pars triangularis to the insula (Tr-Ins), the right pars triangularis to the superior frontal cortex (Tr-SF), the right pars opercularis to the precentral cortex (Op-Prc), as well as bundles within the right LOF-RMF and Or-Ins. Furthermore, a significant positive correlation between NODDI value averaged from the cluster and Hamiton Depression Scale (HAMD) scores was observed (r = 0.35, p < 0.05, Fig. 2).

Conclusions:

Our findings demonstrate that ECT induces significant microstructural changes in SWM tracts in MDD patients, characterized by decreased NODDI values and increased fweAD values in specific regions, including key frontal and insular connections. Importantly, the positive correlation between NODDI values and HAMD scores highlights the potential of SWM alterations as biomarkers of symptom severity and therapeutic response, offering valuable insights into the neural mechanisms underlying ECT.

Brain Stimulation:

Non-invasive Electrical/tDCS/tACS/tRNS

Disorders of the Nervous System:

Psychiatric (eg. Depression, Anxiety, Schizophrenia) ¹

Emotion, Motivation and Social Neuroscience:

Emotion and Motivation Other ²

Keywords:

Affective Disorders

MRI

Tractography

^1|2Indicates the priority used for review

Abstract Information

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Please indicate below if your study was a "resting state" or "task-activation” study.

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Healthy subjects only or patients (note that patient studies may also involve healthy subjects):

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Were any human subjects research approved by the relevant Institutional Review Board or ethics panel? NOTE: Any human subjects studies without IRB approval will be automatically rejected.

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Structural MRI

Diffusion MRI

For human MRI, what field strength scanner do you use?

3.0T

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FSL

Provide references using APA citation style.

Gryglewski, G., Seiger, R., Baldinger-Melich, P., Unterholzner, J., Spurny, B., Vanicek, T., . . . Lanzenberger, R. (2020). Changes in White Matter Microstructure After Electroconvulsive Therapy for Treatment-Resistant Depression. International Journal of Neuropsychopharmacology, 23(1), 20-25. https://doi.org/10.1093/ijnp/pyz059

Guevara, M., Román, C., Houenou, J., Duclap, D., Poupon, C., Mangin, J. F., & Guevara, P. (2017). Reproducibility of superficial white matter tracts using diffusion-weighted imaging tractography. Neuroimage, 147, 703-725. https://doi.org/https://doi.org/10.1016/j.neuroimage.2016.11.066

Ottosson, J.-O., & Odeberg, H. (2012). Evidence-based electroconvulsive therapy. Acta Psychiatrica Scandinavica, 125(3), 177-184. https://doi.org/https://doi.org/10.1111/j.1600-0447.2011.01812.x

Ousdal, O. T., Brancati, G. E., Kessler, U., Erchinger, V., Dale, A. M., Abbott, C., & Oltedal, L. (2022). The Neurobiological Effects of Electroconvulsive Therapy Studied Through Magnetic Resonance: What Have We Learned, and Where Do We Go? Biological Psychiatry, 91(6), 540-549. https://doi.org/https://doi.org/10.1016/j.biopsych.2021.05.023

Repple, J., Meinert, S., Bollettini, I., Grotegerd, D., Redlich, R., Zaremba, D., . . . Dannlowski, U. (2020). Influence of electroconvulsive therapy on white matter structure in a diffusion tensor imaging study. Psychological Medicine, 50(5), 849-856. https://doi.org/10.1017/S0033291719000758

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