Electroconvulsive therapy increases brain volume in major depression: a systematic review and meta-analysis

2018 ◽  
Vol 138 (3) ◽  
pp. 180-195 ◽  
Author(s):  
K. Gbyl ◽  
P. Videbech
Keyword(s):  
Systematic Review ◽  
Major Depression ◽  
Electroconvulsive Therapy ◽  
Brain Volume ◽  
Meta Analysis

scholarly journals Effect of electroconvulsive therapy on hippocampal and amygdala volumes: systematic review and meta-analysis

2018 ◽  
Vol 212 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Akihiro Takamiya ◽  
Jun Ku Chung ◽  
Kuo-ching Liang ◽  
Ariel Graff-Guerrero ◽  
Masaru Mimura ◽  
...  
Keyword(s):  
Systematic Review ◽  
Electroconvulsive Therapy ◽  
Animal Studies ◽  
Brain Volume ◽  
Meta Analysis ◽  
Brain Structures ◽  
Volume Increase ◽  
Left Hippocampus ◽  
Before And After ◽  
Underlying Mechanisms

BackgroundElectroconvulsive therapy (ECT) is one of the most effective treatments for depression, although the underlying mechanisms remain unclear. Animal studies have shown that electroconvulsive shock induced neuroplastic changes in the hippocampus.AimsTo summarise volumetric magnetic resonance imaging studies investigating the effects of ECT on limbic brain structures.MethodA systematic review and meta-analysis was conducted to assess volumetric changes of each side of the hippocampus and amygdala before and after ECT. Standardised mean difference (SMD) was calculated.ResultsA total of 8 studies (n = 193) were selected for our analyses. Both right and left hippocampal and amygdala volumes increased after ECT. Meta-regression analyses revealed that age, percentage of those responding and percentage of those in remission were negatively associated with volume increases in the left hippocampus.ConclusionsECT increased brain volume in the limbic structures. The clinical relevance of volume increase needs further investigation.Declaration of interestNone.

scholarly journals Does lithium prevent relapse following successful electroconvulsive therapy for major depression? A systematic review and meta‐analysis

2021 ◽  
Author(s):  
Simon Lambrichts ◽  
Johan Detraux ◽  
Kristof Vansteelandt ◽  
Axel Nordenskjöld ◽  
Jasmien Obbels ◽  
...  
Keyword(s):  
Systematic Review ◽  
Major Depression ◽  
Electroconvulsive Therapy ◽  
Meta Analysis

scholarly journals Influence of an adjuvant antidepressant on the efficacy of electroconvulsive therapy: A systematic review and meta-analysis

2020 ◽  
pp. 000486742095254
Author(s):  
Esther M Pluijms ◽  
Astrid M Kamperman ◽  
Witte JG Hoogendijk ◽  
Tom K Birkenhäger ◽  
Walter W van den Broek
Keyword(s):  
Systematic Review ◽  
Major Depression ◽  
Confidence Interval ◽  
Monoamine Oxidase ◽  
Electroconvulsive Therapy ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Tricyclic Antidepressants ◽  
Meta Analysis ◽  
Monoamine Oxidase Inhibitors ◽  
Noradrenaline Reuptake

Objective: The primary indication for electroconvulsive therapy is medication-resistant major depression. There is some evidence that combining electroconvulsive therapy with an antidepressant, instead of electroconvulsive therapy monotherapy, might improve remission rates. However, data on this topic have not been systematically studied. We undertook a systematic review and meta-analysis to determine the effectiveness of an adjuvant antidepressant during electroconvulsive therapy for major depression. Methods: Embase, Medline Ovid, Web of Science, Cochrane Central, PsychINFO Ovid and Google Scholar were searched up to January 2019. Randomized controlled trials and cohort studies reporting on the influence of an adjuvant antidepressant on the efficacy of electroconvulsive therapy for major depression were included. Authors independently screened records, extracted data and assessed study quality. We reported this systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Nine studies were included in the meta-analysis. The meta-analysis revealed a significant advantage of adjuvant antidepressants versus placebo. The overall effect size per category of antidepressant was as follows: tricyclic antidepressants: Hedges’ g 0.32 (95% confidence interval: [0.14, 0.51]) ( k = 6) with low heterogeneity ( I2: 4%, p = 0.39); selective serotonin reuptake inhibitors/serotonin noradrenaline reuptake inhibitors: Hedges’ g 0.27 (95% confidence interval: [0.03, 0.52]) ( k = 2) with a lack of heterogeneity ( I2: 0%, p = 0.89); and monoamine oxidase inhibitors: Hedges’ g 0.35 (95% confidence interval: [−0.07, 0.77]) with moderate heterogeneity ( I2: 43%, p = 0.17) ( k = 3). Conclusion: An adjuvant antidepressant enhances the efficacy of electroconvulsive therapy for major depression. Tricyclic antidepressants, selective serotonin reuptake inhibitors/serotonin noradrenaline reuptake inhibitors and monoamine oxidase inhibitors showed the same effect size. However, the effect sizes of tricyclic antidepressants and monoamine oxidase inhibitors are most likely underestimated, due to insufficient doses in most of the included studies. We recommend the routine use of an adequately dosed antidepressant during electroconvulsive therapy for major depression.

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