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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO092

Volumetric and neurochemical changes in the brain as potential markers of improvement in treatment-resistant depression following electroconvulsive therapy

VOLUMETRIC AND NEUROCHEMICAL CHANGES IN BRAIN AS PUTATIVE MARKERS OF IMPROVEMENT IN TREATMENT-RESISTANT DEPRESSION FOLLOWING ELECTROCONVULSIVE THERAPY

Electroconvulsive therapy was found to be associated with both neurochemical and structural brain changes in treatment-resistant depression.

The study aimed to investigate changes in brain structure and neural metabolites in treatment-resistant depression (TRD) using magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). At baseline, 39 patients with TRD and 35 healthy controls (HCs) were assessed, and 24 patients underwent repeat imaging at follow-up after electroconvulsive therapy (ECT); voxels were acquired from the anterior cingulate cortex (ACC) and hippocampus using the PRESS sequence, volumetric analysis was performed with FreeSurfer 7.2.0 and Osprey 2.6.6, and statistical analyses were conducted using SPSS 20.0; MADRS and HAM-D were used for clinical assessment. At baseline, glutamate–glutamine (Glx) levels in the ACC were higher in patients than in controls (14.28±5.68 versus 12.07±3.40; p = 0.048); the difference in ACC myo-inositol levels did not reach statistical significance (8.37±2.82 versus 7.40±1.33; p = 0.063), and there were no significant differences in hippocampal metabolites. Following ECT, myo-inositol levels in the ACC increased (from 8.67±2.02 to 8.81±2.18; p = 0.025), while no significant changes were detected in other ACC or hippocampal metabolites. Comparisons between patients and controls revealed differences in the volumes of the left caudate, right and left cuneus, and left pallidum; comparisons between baseline and follow-up showed increases in the volumes of the left putamen, right hippocampus, right amygdala, right caudal and rostral anterior cingulate, right paracentral region, right postcentral region, and right insula. Correlation analysis showed that ACC Glx levels were positively correlated with baseline HAM-D scores (r = 0.455; p = 0.044), while right postcentral gyrus volume was negatively correlated with MADRS scores (r = -0.468; p = 0.021). In conclusion, ECT was associated with both neurochemical and morphological changes in TRD; the findings were interpreted as supporting glial involvement and neuroplasticity, as well as structural plasticity in regions involved in mood regulation, cognition, and treatment response.

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