The Global ECT-MRI Research Collaboration (GEMRIC) has produced startling findings [1e3]. Over the last several years it has become evident that electroconvulsive therapy (ECT) results in increased hippocampal and amygdala volume [4,5], with considerable speculation that structural or functional changes in these regions are linked to therapeutic or adverse cognitive effects [6,7]. However, with a large sample treated at multiple sites in Europe and the US, GEMRIC observed that 79 of 84 grey matter regions increased in volume shortly following a course of ECT [1]. These regions included the hippocampus and amygdala, but were far more widely distributed than had been anticipated. Univariate analyses indicated that changes in some regions were associated with electrode placement (bifrontotemporal, BL vs. right unilateral ECT, RUL), as well as the number of ECT treatments, but there were no associations with clinical outcome. In contrast, Mulders et al. [2], using a subset of the same data, applied multivariate methods to identify discriminant spatial patterns that distinguished ECT responders and nonresponders. Patterns involving specific lateral and midline cortical and striatal structures contributed to the discrimination, with increases in some regions associated with response, while other regional increases were linked to nonresponse. Notably, the hippocampus and amygdala did not contribute to the discrimination of the clinical outcome groups. In part as a validation, Mulders et al. [2] applied the same analytic method to isolate a discriminant spatial pattern that distinguished BL and RUL ECT. In this case, volumetric increases in left medial temporal lobe structures distinguished the interventions, as might be expected given their differences in current density patterns [8,9], with RUL ECT having less impact on these structures. Indeed, another GEMRIC report suggests that the extent of structural change following ECT is related to the local electrical field strength during stimulus delivery [3]. The most secure finding in the GEMRIC reports is that there are wide spread volumetric increases in both cortical and subcortical grey matter regions within a week or two of completing an acute

中文翻译：

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电休克疗法对脑灰质体积的影响：这意味着什么？

全球 ECT-MRI 研究合作 (GEMRIC) 产生了惊人的发现 [1e3]。在过去几年中，电休克疗法 (ECT) 导致海马和杏仁核体积增加 [4,5] 已变得很明显 [4,5]，有相当多的推测认为这些区域的结构或功能变化与治疗或不良认知影响有关 [6, 7]。然而，通过在欧洲和美国的多个地点处理大量样本，GEMRIC 观察到 84 个灰质区域中有 79 个在 ECT 疗程后不久体积增加 [1]。这些区域包括海马体和杏仁核，但分布比预期的要广泛得多。单变量分析表明，某些区域的变化与电极放置有关（双额颞叶、BL 与右侧单侧 ECT、RUL），以及 ECT 治疗的次数，但与临床结果没有关联。相比之下，Mulders 等人。[2]，使用相同数据的一个子集，应用多变量方法来识别区分 ECT 响应者和非响应者的判别空间模式。涉及特定外侧和中线皮质和纹状体结构的模式有助于区分，某些区域的增加与反应有关，而其他区域的增加与无反应有关。值得注意的是，海马体和杏仁核对临床结果组的歧视没有贡献。部分作为验证，Mulders 等人。[2] 应用相同的分析方法来隔离区分 BL 和 RUL ECT 的判别空间模式。在这种情况下，左侧内侧颞叶结构的体积增加区分了干预措施，正如考虑到它们在电流密度模式上的差异所预期的那样 [8,9]，而 RUL ECT 对这些结构的影响较小。事实上，另一份 GEMRIC 报告表明，ECT 后结构变化的程度与刺激传递过程中的局部电场强度有关 [3]。GEMRIC 报告中最可靠的发现是，在完成急性发作后的一两周内，皮质和皮质下灰质区域的体积都有广泛的增加。另一项 GEMRIC 报告表明，ECT 后结构变化的程度与刺激传递过程中的局部电场强度有关 [3]。GEMRIC 报告中最可靠的发现是，在完成急性发作后的一两周内，皮质和皮质下灰质区域的体积都有广泛的增加。另一份 GEMRIC 报告表明，ECT 后结构变化的程度与刺激传递过程中的局部电场强度有关 [3]。GEMRIC 报告中最可靠的发现是，在完成急性发作后的一两周内，皮质和皮质下灰质区域的体积都有广泛的增加。