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Hippocampal Volume and Memory Impairment after Electroconvulsive Therapy in Patients with Depression

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OBJECTIVE: Patients hesitate to consent to electroconvulsive therapy (ECT) because of the fear of memory impairment. The mechanisms underlying this impairment are unclear, but several observations suggest hippocampal alterations may be involved. We investigated whether ECT-induced change in hippocampal volume correlates with memory impairment.

METHODS: Using a 3 T MRI scanner, we acquired brain images and assessed cognitive performance in 22 severely depressed patients at three time points: (1) before ECT series, (2) within one week after the series, and (3) at six-month follow-up. The hippocampus was segmented into subregions using FreeSurfer. The dentate gyri (DG) were the primary regions of interest (ROIs) and major hippocampal subregions secondary ROIs. Cognitive performance was assessed using the Screen for Cognitive Impairment in Psychiatry and verbal memory using the Verbal Learning subtest. The linear mixed model and the repeated-measures correlation were used for statistical analyses.

RESULTS: ECT induced an increase in the right and left DG volume with co-occurring worsening in verbal memory, and these changes were within-patients negatively correlated (right DG, r rm = -0.85, df = 18, p = 0.0000002; left DG, r rm = -0.58, df = 18, p = 0.008). At a six-month follow-up, the volume of both DG decreased with a co-occurring improvement in verbal memory, and these changes were negatively correlated in the right DG (r rm = -0.64, df = 15, p = 0.005). Volume increases in 14 secondary ROIs were also negatively correlated with memory impairment.

CONCLUSION: ECT-related transient increases in the volume of major hippocampal subregions within-patients are associated with memory impairment. Hippocampal alterations following ECT should be the focus in searching for causes of the cognitive side effects.

OriginalsprogEngelsk
TidsskriftActa Psychiatrica Scandinavica
Vol/bind143
Udgave nummer3
Sider (fra-til)238-252
Antal sider15
ISSN0001-690X
DOI
StatusUdgivet - mar. 2021

Bibliografisk note

Funding Information:
Krzysztof Gbyl declared unrestricted grants from Augustinusfonden, Axel Muusfeldts Fond, Beckett‐Fonden, A.P. Møllers Fonden: Fonden til Lægevidenskabens Fremme, Helsefonden, Ivan Nielsens fond for personer med speciale sindslidelser, Læge Gerhard Linds Legat, Lundbeckfonden, Jascha Fonden, and Psykiatrisk Forskningsfond af 1967. Mette Marie Støttrup, Jayachandra Mitta Raghava, Song Xue Jie, and Poul Videbech reported no competing financial interests or potential conflicts of interest.

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