Elevated body weight modulates subcortical volume change and associated clinical response following electroconvulsive therapy

Nils Opel; Katherine L. Narr; Christopher Abbott; Miklos Argyelan; Randall Espinoza; Louise Emsell; Filip Bouckaert; Pascal Sienaert; Mathieu Vandenbulcke; Pia Nordanskog; Jonathan Repple; Erhan Kavakbasi; Martin B. Jorgensen; Olaf B. Paulson; Lars G. Hanson; Annemieke Dols; Eric van Exel; Mardien L. Oudega; Akihiro Takamiya; Taishiro Kishimoto; Olga Therese Ousdal; Jan Haavik; Åsa Hammar; Ketil Joachim Oedegaard; Ute Kessler; Hauke Bartsch; Anders M. Dale; Bernhard T. Baune; Udo Dannlowski; Leif Oltedal; Ronny Redlich

doi:10.1503/jpn.200176

Elevated body weight modulates subcortical volume change and associated clinical response following electroconvulsive therapy

J Psychiatry Neurosci. 2021 Jul 5;46(4):E418-E426. doi: 10.1503/jpn.200176.

Authors

Nils Opel¹, Katherine L. Narr¹, Christopher Abbott¹, Miklos Argyelan¹, Randall Espinoza¹, Louise Emsell¹, Filip Bouckaert¹, Pascal Sienaert¹, Mathieu Vandenbulcke¹, Pia Nordanskog¹, Jonathan Repple¹, Erhan Kavakbasi¹, Martin B. Jorgensen¹, Olaf B. Paulson¹, Lars G. Hanson¹, Annemieke Dols¹, Eric van Exel¹, Mardien L. Oudega¹, Akihiro Takamiya¹, Taishiro Kishimoto¹, Olga Therese Ousdal¹, Jan Haavik¹, Åsa Hammar¹, Ketil Joachim Oedegaard¹, Ute Kessler¹, Hauke Bartsch¹, Anders M. Dale¹, Bernhard T. Baune¹, Udo Dannlowski¹, Leif Oltedal¹, Ronny Redlich¹

Affiliation

¹ From the Institute for Translational Psychiatry, University of Münster, Münster, Germany (Opel, Repple, Dannlowski, Redlich); Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany (Kavakbasi, Baune); the Departments of Neurology, Psychiatry, and Biobehavioral Sciences, University of California, Los Angeles, CA (Narr); the Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, NM (Abbott); the Institute of Behavioral Science, Feintein Institutes for Medical Research, Manhasset, NY (Argyelan); the Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY (Argyelan); the Department of Psychiatry, University of California, Los Angeles (Espinoza); the Department of Geriatric Psychiatry, University Psychiatric Center KU Leuven, KU Leuven, Leuven, Belgium (Emsell, Vandenbulcke); the KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry & Geriatric Psychiatry, University Psychiatric Center KU Leuven, Belgium (Bouckaert); the Academic Center for ECT and Neurostimulation (AcCENT), University Psychiatric Center (UPC)-KU Leuven, Kortenberg, Belgium (Sienaert); the Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden (Nordanskog); the Psychiatric Center Copenhagen (Rigshospitalet), Mental Health Services of the Capital Region of Denmark, Copenhagen, Denmark (Jorgensen); the Neurobiology Research Unit, Rigshospitalet and University of Copenhagen, Denmark (Paulson); the Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark (Hanson); the Center for Magnetic Resonance, Department of Health Technology, Technical University of Denmark, Kgs, Lyngby, Denmark (Hanson); the GGZ in Geest Specialized Mental Health Care, Amsterdam, the Netherlands (Dols, Van Exel, Oudega); the Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands (Dols, van Exel, Oudega); the Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan (Takamiya, Kishimoto); the Department of Radiology, Haukeland University Hospital, Bergen, Norway (Ousdal); the Department of Biomedicine, University of Bergen, Bergen, Norway (Haavik); the Division of Psychiatry, Haukeland University Hospital, Bergen, Norway (Haavik, Hammar); the Department of Biological and Medical Psychology, University of Bergen, Norway (Hammar); the NORMENT, Department of Psychiatry, Haukeland University Hospital, Bergen, Norway (Oedegaard, Kessler); the Department of Clinical Medicine, University of Bergen, Bergen, Norway (Oedegaard, Kessler, Oltedal); the Department of Radiology, University of California, San Diego, La Jolla, California (Bartsch); the Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway (Bartsch, Oltedal); the Departments of Radiology, Neurosciences, and Psychiatry, University of California, San Diego (Dale); the Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, California (Dale); the Department of Psychiatry, University of Melbourne, Melbourne, Australia (Baune); the The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia (Baune); and the Department of Psychology, University of Halle, Halle, Germany (Redlich).

Abstract

Background: Obesity is a frequent somatic comorbidity of major depression, and it has been associated with worse clinical outcomes and brain structural abnormalities. Converging evidence suggests that electroconvulsive therapy (ECT) induces both clinical improvements and increased subcortical grey matter volume in patients with depression. However, it remains unknown whether increased body weight modulates the clinical response and structural neuroplasticity that occur with ECT.

Methods: To address this question, we conducted a longitudinal investigation of structural MRI data from the Global ECT-MRI Research Collaboration (GEMRIC) in 223 patients who were experiencing a major depressive episode (10 scanning sites). Structural MRI data were acquired before and after ECT, and we assessed change in subcortical grey matter volume using FreeSurfer and Quarc.

Results: Higher body mass index (BMI) was associated with a significantly lower increase in subcortical grey matter volume following ECT. We observed significant negative associations between BMI and change in subcortical grey matter volume, with pronounced effects in the thalamus and putamen, where obese participants showed increases in grey matter volume that were 43.3% and 49.6%, respectively, of the increases found in participants with normal weight. As well, BMI significantly moderated the association between subcortical grey matter volume change and clinical response to ECT. We observed no significant association between BMI and clinical response to ECT.

Limitations: Because only baseline BMI values were available, we were unable to study BMI changes during ECT and their potential association with clinical and grey matter volume change.

Conclusion: Future studies should take into account the relevance of body weight as a modulator of structural neuroplasticity during ECT treatment and aim to further explore the functional relevance of this novel finding.

MeSH terms

Body Weight*
Brain / diagnostic imaging
Brain / pathology*
Depressive Disorder, Major / diagnostic imaging
Depressive Disorder, Major / pathology*
Depressive Disorder, Major / therapy*
Electroconvulsive Therapy*
Female
Gray Matter / diagnostic imaging
Gray Matter / pathology*
Humans
Male
Middle Aged

Abstract

MeSH terms

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