GEMRIC

The Global ECT-MRI Research Collaboration was founded with a belief that collaboration and mega-analysis of combined data will lead to new knowledge that can be generalized across individual research sites.

Major unipolar and bipolar depression are among the most common mental disorders and, according to the WHO, depression is now the leading cause of disability worldwide. Depression is very difficult to treat. Medication and cognitive therapy are effective but about 30% of patients do not respond to standard treatments even after multiple treatment steps. In contrast, electroconvulsive therapy (ECT) leads to substantial improvement in about 50-70% of these patients with resistant, severe, and sometimes life-threatening, depression (Husain et al., 2004). ECT is a medical procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief generalized seizure under tightly controlled conditions. Since ECT has a broad indication for different types of treatment resistant depression, it is important to explore whether in the future it is useful to extend the indication and include the need for stratification as a mean of personalisation. To this end, researchers from Bergen have taken the initiative to form a worldwide multimodal neuroimaging consortium that will investigate the neural underpinnings of ECT with the ultimate goal to develop markers predicting treatment response and derive mechanistic insights to develop new treatment options.

Within GEMRIC we have the world’s largest data sample with clinical and MRI neuroimaging data before and after ECT – our initial study will include up to 550 subjects (including controls). In our next study we aim at increasing the sample size to 2000 subjects. GEMRIC uses state-of-the-art imaging tools, developed in a world leading laboratory (Dr. Anders M Dale, UCSD) as well as tools developed by GEMRIC collaborators. Instead of distributing data among collaborators, our philosophy is to port all data to a common data portal for pooled mega-analysis using advanced image-analysis pipelines that are shared and implemented on this server. This way, data security can be kept at a very high level while at the same time almost any analysis pipeline can be used. Pipelines are set up as Docker containers – which means standardization, independence of operating systems and reproducible results.

New collaborators are welcome!

Project PI Leif Oltedal

 

Upcoming events:

2019:
November 6th: virtual meeting

2020:
April 30th: Meeting at SOBP 2020 New York
November 4th: virtual meeting

2021:
April 29th: Meeting at SOBP 2021 San Diego, California
September 2021: 3rd Bergen workshop

News

Genetics of ECT International Consortium

GEMRIC recommends that sites contribute to the Genetics of ECT International consortium (GenECT-ic). GenECT-ic is a collaboration between ECT providers and researchers all over the globe. The goal of GenECT-ic is to shed light on the genetics involved in severe depression (unipolar and bipolar depression) and patient response to ECT. GenECT-ic is one of the projects currently being run as part of the Psychiatric Genomics Consortium.

Contact: bernhard.baune@ukmuenster.de (PI)

Related Publications

2018

  • L. Oltedal, K. L. Narr, C. Abbott, A. Anand, M. Argyelan, H. Bartsch, U. Dannlowski, A. Dols, P. van Eijndhoven, L. Emsell, V. J. Erchinger, R. Espinoza, T. Hahn, L. G. Hanson, G. Hellemann, M. B. Jorgensen, U. Kessler, M. L. Oudega, O. B. Paulson, R. Redlich, P. Sienaert, M. L. Stek, I. Tendolkar, M. Vandenbulcke, K. J. Oedegaard, and A. M. Dale, “Volume of the Human Hippocampus and Clinical Response Following Electroconvulsive Therapy,” Biological Psychiatry, vol. 84, iss. 8, pp. 574-581, 2018. doi:10.1016/j.biopsych.2018.05.017
    [BibTeX] [Abstract] [Download PDF]

    Hippocampal enlargements are commonly reported after electroconvulsive therapy (ECT). To clarify mechanisms, we examined if ECT-induced hippocampal volume change relates to dose (number of ECT sessions and electrode placement) and acts as a biomarker of clinical outcome. Longitudinal neuroimaging and clinical data from 10 independent sites participating in the Global ECT-Magnetic Resonance Imaging Research Collaboration (GEMRIC) were obtained for mega-analysis. Hippocampal volumes were extracted from structural magnetic resonance images, acquired before and after patients (n = 281) experiencing a major depressive episode completed an ECT treatment series using right unilateral and bilateral stimulation. Untreated nondepressed control subjects (n = 95) were scanned twice. The number of ECT sessions and electrode placement impacts the extent and laterality of hippocampal enlargement, but volume change is not positively associated with clinical outcome. The results suggest that the high efficacy of ECT is not explained by hippocampal enlargement, which alone might not serve as a viable biomarker for treatment outcome.

    @article{Oltedal_BioPsych_2018,
    title = "Volume of the Human Hippocampus and Clinical Response Following Electroconvulsive Therapy",
    journal = "Biological Psychiatry",
    volume = "84",
    number = "8",
    pages = "574 - 581",
    year = "2018",
    note = "Cannabinoids, Ketamine, Connectivity, and Depression",
    issn = "0006-3223",
    doi = "10.1016/j.biopsych.2018.05.017",
    url = "http://www.sciencedirect.com/science/article/pii/S0006322318315348",
    author = "Leif Oltedal and Katherine L. Narr and Christopher Abbott and Amit Anand and Miklos Argyelan and Hauke Bartsch and Udo Dannlowski and Annemieke Dols and Philip van Eijndhoven and Louise Emsell and Vera Jane Erchinger and Randall Espinoza and Tim Hahn and Lars G. Hanson and Gerhard Hellemann and Martin Balslev Jorgensen and Ute Kessler and Mardien L. Oudega and Olaf B. Paulson and Ronny Redlich and Pascal Sienaert and Max L. Stek and Indira Tendolkar and Mathieu Vandenbulcke and Ketil J. Oedegaard and Anders M. Dale",
    abstract = {
    
    Hippocampal enlargements are commonly reported after electroconvulsive therapy (ECT). To clarify mechanisms, we examined if ECT-induced hippocampal volume change relates to dose (number of ECT sessions and electrode placement) and acts as a biomarker of clinical outcome.
    
    Longitudinal neuroimaging and clinical data from 10 independent sites participating in the Global ECT-Magnetic Resonance Imaging Research Collaboration (GEMRIC) were obtained for mega-analysis. Hippocampal volumes were extracted from structural magnetic resonance images, acquired before and after patients (n = 281) experiencing a major depressive episode completed an ECT treatment series using right unilateral and bilateral stimulation. Untreated nondepressed control subjects (n = 95) were scanned twice.
    
    The number of ECT sessions and electrode placement impacts the extent and laterality of hippocampal enlargement, but volume change is not positively associated with clinical outcome. The results suggest that the high efficacy of ECT is not explained by hippocampal enlargement, which alone might not serve as a viable biomarker for treatment outcome.}
    }

2017

  • L. Oltedal, H. Bartsch, O. J. E. Sørhaug, U. Kessler, C. Abbott, A. Dols, M. L. Stek, L. Ersland, L. Emsell, P. van Eijndhoven, and others, “The Global ECT-MRI Research Collaboration (GEMRIC): Establishing a multi-site investigation of the neural mechanisms underlying response to electroconvulsive therapy,” NeuroImage: Clinical, vol. 14, pp. 422-432, 2017. doi:10.1016/j.nicl.2017.02.009
    [BibTeX] [Download PDF]
    @article{oltedal2017global,
      title={The Global ECT-MRI Research Collaboration (GEMRIC): Establishing a multi-site investigation of the neural mechanisms underlying response to electroconvulsive therapy},
      author={Oltedal, Leif and Bartsch, Hauke and S{\o}rhaug, Ole Johan Evjenth and Kessler, Ute and Abbott, Christopher and Dols, Annemieke and Stek, Max L and Ersland, Lars and Emsell, Louise and van Eijndhoven, Philip and others},
      journal={NeuroImage: Clinical},
      volume={14},
      pages={422--432},
      year={2017},
      publisher={Elsevier},
      url = {https://www.sciencedirect.com/science/article/pii/S2213158217300438},
      doi = "10.1016/j.nicl.2017.02.009"  
    }