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Longitudinal changes in hippocampal microstructure and functional connectivity in MDD following ECT

Poster No:

Submission Type:

Abstract Submission

Authors:

Zhiang Su¹^,2, Xinhu Yang¹^,2, Sha Liu¹^,2, Liangda Zhong¹^,2, Jing Wu¹^,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:

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

Co-Author(s):

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

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

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

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

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 rapid and effective treatment for major depressive disorder (MDD), especially in cases with high risks of suicidal behavior (Ottosson & Odeberg, 2012). Numerous structural neuroimaging studies highlighted hippocampal volume changes associated with ECT (Gbyl & Videbech, 2018), only a few examined diffusivity properties of the hippocampus (Jorgensen et al., 2016; Yrondi et al., 2019). Moreover, the specific effects of ECT on the diffusivity properties of hippocampal subregions and their functional connectivity remain largely unexplored. To address this gap, our study aims to investigate the microstructural characteristics of hippocampal subregions using neurite orientation dispersion and density imaging (NODDI), and explore their associated functional connectivity in patients with MDD undergoing ECT.

Methods:

We collected longitudinal multi-shell diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (fMRI) datasets from 16 patients, both prior to and following ECT. Following preprocessing, we utilized the Brainetome atlas (Fan et al., 2016) to segment the hippocampus into four regions (Fig. 1a): the left rostral and caudal hippocampus (L_rHip/L_cHip) and the right rostral and caudal hippocampus (R_rHip/R_cHip). For each region, we extracted NODDI values and estimated seed-based functional connectivity. To examine diffusivity and connectivity alterations associated with ECT, we performed pairwise t-tests to compare pre- and post-ECT data for each hippocampal subregion and its corresponding functional connectivity.

Results:

Compared to the pre-ECT state, patients showed a significant decrease in NODDI values in the L_rHip, R_rHip, and L_cHip (p < 0.05, Fig. 1b) following ECT. Additionally, seed-based FC analysis revealed significantly increased connectivity between the L_cHip and the left cerebellum, as well as the middle and inferior temporal, fusiform, and inferior occipital cortices (Fig. 2a). This increased connectivity was negatively correlated with Hamiton Depression Scale (HAMD) scores (r = -0.75, p < 0.01, Fig. 2b).

Conclusions:

In conclusion, our findings suggest that ECT may induce changes in both the microstructural properties and FC of hippocampal regions. The observed decreases in NODDI values may indicate alterations in neural tissue integrity of the hippocampus, while the enhanced FC may reflect a broader network reorganization. Together, these results underscore that ECT may promote neuroplasticity in key regions involved in emotion regulation and cognition, offering valuable insights into the mechanisms underlying its therapeutic effects in MDD.

Brain Stimulation:

Non-invasive Electrical/tDCS/tACS/tRNS ¹

Disorders of the Nervous System:

Psychiatric (eg. Depression, Anxiety, Schizophrenia)

Modeling and Analysis Methods:

Diffusion MRI Modeling and Analysis ²

Novel Imaging Acquisition Methods:

BOLD fMRI

Diffusion MRI

Keywords:

ADULTS

Affective Disorders

MRI

White Matter

^1|2Indicates the priority used for review

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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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Please indicate which methods were used in your research:

Diffusion MRI

Behavior

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

3.0T

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Provide references using APA citation style.

Fan, L., Li, H., Zhuo, J., Zhang, Y., Wang, J., Chen, L., . . . Jiang, T. (2016). The Human Brainnetome Atlas: A New Brain Atlas Based on Connectional Architecture. Cerebral cortex, 26(8), 3508-3526. https://doi.org/10.1093/cercor/bhw157

Gbyl, K., & Videbech, P. (2018). Electroconvulsive therapy increases brain volume in major depression: a systematic review and meta-analysis. Acta Psychiatrica Scandinavica, 138(3), 180-195. https://doi.org/https://doi.org/10.1111/acps.12884

Jorgensen, A., Magnusson, P., Hanson, L. G., Kirkegaard, T., Benveniste, H., Lee, H., . . . Jorgensen, M. B. (2016). Regional brain volumes, diffusivity, and metabolite changes after electroconvulsive therapy for severe depression. Acta Psychiatrica Scandinavica, 133(2), 154-164. https://doi.org/https://doi.org/10.1111/acps.12462

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

Yrondi, A., Nemmi, F., Billoux, S., Giron, A., Sporer, M., Taib, S., . . . Arbus, C. (2019). Significant Decrease in Hippocampus and Amygdala Mean Diffusivity in Treatment-Resistant Depression Patients Who Respond to Electroconvulsive Therapy [Brief Research Report]. Frontiers in Psychiatry, 10. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2019.00694

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