Pre-treatment amygdala volume predicts electroconvulsive therapy response

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Background: Electroconvulsive therapy (ECT) is an effective treatment for patients with severe depression. Knowledge on factors predicting therapeutic response may help to identify patients who will benefit most from the intervention. Based on the neuroplasticity hypothesis, volumes of the amygdala and hippocampus are possible candidates for predict¬ing treatment outcome. Therefore, this prospective cohort study examines the predictive value of amygdala and hippocampal volumes for the effectiveness of ECT. Methods: Prior to ECT 53 severely unipolar depressed patients [mean age 57 ± 14 years; 40% (n = 21) male] received structural magnetic resonance imaging (MRI) at 1.5T. Nor¬malized amygdala and hippocampal volumes were calculated based on automatic seg¬mentation by FreeSurfer (FS). Regression analyses were used to test if the normalized volumes could predict the response to a course of ECT based on the Montgomery-Asberg Depression Rating Scale (MADRS) scores. Results: A larger amygdala volume independently and significantly predicted a lower post-ECT MADRS score (β =-0.347, P = 0.013). The left amygdala volume had greater predictive value for treatment outcome relative to the right amygdala volume. Hippocampal volume had no independent predictive value. Conclusion: A larger pre-treatment amygdala volume predicted more effective ECT inde¬pendent of other known predictors. Almost all patients continued their medication during the study, which might have influenced the course of treatment in ways that were not taken into account. [ABSTRACT FROM AUTHOR] Copyright of Frontiers in Psychiatry is the property of Frontiers Media S.A. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)




ten Doesschate, F., van Eijndhoven, P., Tendolkar, I., van Wingen, G. A., & van Waarde, J. A. (2014). Pre-treatment amygdala volume predicts electroconvulsive therapy response. Frontiers in Psychiatry, 5(NOV).

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