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Electroconvulsive therapy, electric field, neuroplasticity, and clinical outcomes.

Publication ,  Journal Article
Deng, Z-D; Argyelan, M; Miller, J; Quinn, DK; Lloyd, M; Jones, TR; Upston, J; Erhardt, E; McClintock, SM; Abbott, CC
Published in: Molecular psychiatry
March 2022

Electroconvulsive therapy (ECT) remains the gold-standard treatment for patients with depressive episodes, but the underlying mechanisms for antidepressant response and procedure-induced cognitive side effects have yet to be elucidated. Such mechanisms may be complex and involve certain ECT parameters and brain regions. Regarding parameters, the electrode placement (right unilateral or bitemporal) determines the geometric shape of the electric field (E-field), and amplitude determines the E-field magnitude in select brain regions (e.g., hippocampus). Here, we aim to determine the relationships between hippocampal E-field strength, hippocampal neuroplasticity, and antidepressant and cognitive outcomes. We used hippocampal E-fields and volumes generated from a randomized clinical trial that compared right unilateral electrode placement with different pulse amplitudes (600, 700, and 800 mA). Hippocampal E-field strength was variable but increased with each amplitude arm. We demonstrated a linear relationship between right hippocampal E-field and right hippocampal neuroplasticity. Right hippocampal neuroplasticity mediated right hippocampal E-field and antidepressant outcomes. In contrast, right hippocampal E-field was directly related to cognitive outcomes as measured by phonemic fluency. We used receiver operating characteristic curves to determine that the maximal right hippocampal E-field associated with cognitive safety was 112.5 V/m. Right hippocampal E-field strength was related to the whole-brain ratio of E-field strength per unit of stimulation current, but this whole-brain ratio was unrelated to antidepressant or cognitive outcomes. We discuss the implications of optimal hippocampal E-field dosing to maximize antidepressant outcomes and cognitive safety with individualized amplitudes.

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Published In

Molecular psychiatry

DOI

EISSN

1476-5578

ISSN

1359-4184

Publication Date

March 2022

Volume

27

Issue

3

Start / End Page

1676 / 1682

Related Subject Headings

  • Treatment Outcome
  • Psychiatry
  • Neuronal Plasticity
  • Humans
  • Hippocampus
  • Electroconvulsive Therapy
  • Brain
  • Antidepressive Agents
  • 5203 Clinical and health psychology
  • 5202 Biological psychology
 

Citation

APA
Chicago
ICMJE
MLA
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Deng, Z.-D., Argyelan, M., Miller, J., Quinn, D. K., Lloyd, M., Jones, T. R., … Abbott, C. C. (2022). Electroconvulsive therapy, electric field, neuroplasticity, and clinical outcomes. Molecular Psychiatry, 27(3), 1676–1682. https://doi.org/10.1038/s41380-021-01380-y
Deng, Zhi-De, Miklos Argyelan, Jeremy Miller, Davin K. Quinn, Megan Lloyd, Thomas R. Jones, Joel Upston, Erik Erhardt, Shawn M. McClintock, and Christopher C. Abbott. “Electroconvulsive therapy, electric field, neuroplasticity, and clinical outcomes.Molecular Psychiatry 27, no. 3 (March 2022): 1676–82. https://doi.org/10.1038/s41380-021-01380-y.
Deng Z-D, Argyelan M, Miller J, Quinn DK, Lloyd M, Jones TR, et al. Electroconvulsive therapy, electric field, neuroplasticity, and clinical outcomes. Molecular psychiatry. 2022 Mar;27(3):1676–82.
Deng, Zhi-De, et al. “Electroconvulsive therapy, electric field, neuroplasticity, and clinical outcomes.Molecular Psychiatry, vol. 27, no. 3, Mar. 2022, pp. 1676–82. Epmc, doi:10.1038/s41380-021-01380-y.
Deng Z-D, Argyelan M, Miller J, Quinn DK, Lloyd M, Jones TR, Upston J, Erhardt E, McClintock SM, Abbott CC. Electroconvulsive therapy, electric field, neuroplasticity, and clinical outcomes. Molecular psychiatry. 2022 Mar;27(3):1676–1682.

Published In

Molecular psychiatry

DOI

EISSN

1476-5578

ISSN

1359-4184

Publication Date

March 2022

Volume

27

Issue

3

Start / End Page

1676 / 1682

Related Subject Headings

  • Treatment Outcome
  • Psychiatry
  • Neuronal Plasticity
  • Humans
  • Hippocampus
  • Electroconvulsive Therapy
  • Brain
  • Antidepressive Agents
  • 5203 Clinical and health psychology
  • 5202 Biological psychology