BACKGROUND Electroconvulsive therapy (ECT) is associated with volumetric enlargements of corticolimbic brain regions. However, the pattern of whole-brain structural alterations following ECT remains unresolved. Here, we examined the longitudinal effects of ECT on global and local variations in gray matter, white matter, and ventricle volumes in patients with major depressive disorder as well as predictors of ECT-related clinical response. METHODS Longitudinal magnetic resonance imaging and clinical data from the Global ECT-MRI Research Collaboration (GEMRIC) were used to investigate changes in white matter, gray matter, and ventricle volumes before and after ECT in 328 patients experiencing a major depressive episode. In addition, 95 nondepressed control subjects were scanned twice. We performed a mega-analysis of single subject data from 14 independent GEMRIC sites. RESULTS Volumetric increases occurred in 79 of 84 gray matter regions of interest. In total, the cortical volume increased by mean ± SD of 1.04 ± 1.03% (Cohen's d = 1.01, p < .001) and the subcortical gray matter volume increased by 1.47 ± 1.05% (d = 1.40, p < .001) in patients. The subcortical gray matter increase was negatively associated with total ventricle volume (Spearman's rank correlation ρ = -.44, p < .001), while total white matter volume remained unchanged (d = -0.05, p = .41). The changes were modulated by number of ECTs and mode of electrode placements. However, the gray matter volumetric enlargements were not associated with clinical outcome. CONCLUSIONS The findings suggest that ECT induces gray matter volumetric increases that are broadly distributed. However, gross volumetric increases of specific anatomically defined regions may not serve as feasible biomarkers of clinical response.

中文翻译：

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电休克疗法引起的大脑变化分布广泛

背景电惊厥疗法（ECT）与皮质边缘脑区的体积增大有关。然而，ECT 后全脑结构改变的模式仍未解决。在这里，我们检查了 ECT 对重度抑郁症患者灰质、白质和心室容积的全局和局部变化的纵向影响，以及 ECT 相关临床反应的预测因子。方法 来自全球 ECT-MRI 研究合作 (GEMRIC) 的纵向磁共振成像和临床数据用于调查 328 名经历重度抑郁发作的患者在 ECT 前后白质、灰质和心室容积的变化。此外，对 95 名非抑郁对照受试者进行了两次扫描。我们对来自 14 个独立 GEMRIC 站点的单个受试者数据进行了大型分析。结果 84 个感兴趣的灰质区域中有 79 个发生体积增加。总的来说，皮质体积增加了 1.04 ± 1.03%（Cohen's d = 1.01，p < .001），皮质下灰质体积增加了 1.47 ± 1.05%（d = 1.40，p < .001）耐心。皮层下灰质增加与总心室体积呈负相关（Spearman 等级相关性 ρ = -.44，p < .001），而总白质体积保持不变（d = -0.05，p = .41）。这些变化受 ECT 的数量和电极放置方式的影响。然而，灰质体积增大与临床结果无关。结论 研究结果表明，ECT 引起广泛分布的灰质体积增加。然而，特定解剖学定义区域的总体积增加可能不能作为临床反应的可行生物标志物。