Significant Decrease in Hippocampus and Amygdala Mean Diffusivity in Treatment-Resistant Depression Patients Who Respond to Electroconvulsive Therapy

Antoine Yrondi, Federico Nemmi, Sophie Billoux, Aurélie Giron, Marie Sporer, Simon Taib, Juliette Salles, Damien Pierre, Claire Thalamas, Laurent Schmitt, Patrice Péran, Christophe Arbus, Antoine Yrondi, Federico Nemmi, Sophie Billoux, Aurélie Giron, Marie Sporer, Simon Taib, Juliette Salles, Damien Pierre, Claire Thalamas, Laurent Schmitt, Patrice Péran, Christophe Arbus

Abstract

Introduction: The hippocampus plays a key role in depressive disorder, and the amygdala is involved in depressive disorder through the key role that it plays in emotional regulation. Electroconvulsive therapy (ECT) may alter the microstructure of these two regions. Since mean diffusivity (MD), is known to be an indirect marker of microstructural integrity and can be derived from diffusion tensor imaging (DTI) scans, we aim to test the hypothesis that treatment-resistant depression (TRD) patients undergoing bilateral (BL) ECT exhibit a decrease of MD in their hippocampus and amygdala. Methods: Patients, between 50 and 70 years of age, diagnosed with TRD were recruited from the University Hospital of Toulouse and assessed clinically (Hamilton Depression Rating Scale, HAM-D) and by DTI scans at three time points: baseline, V2 (during treatment), and V3 within 1 week of completing ECT. Results: We included 15 patients, who were all responders. The left and right hippocampi and the left amygdala showed a significant decrease in MD at V3, compared to baseline [respectively: β = -2.78, t = -1.97, p = 0.04; β = -2.56, t = -2, p = 0.04; β = -2.5, t = -2.3, p = 0.04, false discovery rate (FDR) corrected]. MD did not decrease in the right amygdala. Only the left amygdala was significantly associated with a reduction in HAM-D (ρ = 0.55, p = 0.049, FDR corrected). Conclusion: MD is an indirect microstructural integrity marker, which decreases in the hippocampus and the left amygdala, during BL ECT in TRD populations. This could be interpreted as a normalization of microstructural integrity in these structures.

Keywords: DTI; MRI; depressive disorder; electroconvulsive therapy; mean diffusivity.

Copyright © 2019 Yrondi, Nemmi, Billoux, Giron, Sporer, Taib, Salles, Pierre, Thalamas, Schmitt, Péran and Arbus.

Figures

Figure 1
Figure 1
Single subjects measures and trajectories (in black) and group average and 95% CI (in blue) for V1, V2 and V3. In the left and right hippocampus, and the left amydala, the average MD was significantly lower at V3 than V1 (p = 0.4). Note that MD has been scaled by multiplying its original value by 1000.

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