The hippocampal volume increases after ECT, supporting the hypothesis that hippocampus may play a central role in the treatment of depression.

ObjectiveIn a previous magnetic resonance imaging (MRI) study, we found a significant increase in hippocampal volume immediately after electroconvulsive therapy (ECT) in patients with depression. The aim of this study was to evaluate hippocampal volume up to 1 year after ECT and investigate its possible relation to clinical and cognitive outcome.MethodClinical and cognitive outcome in 12 in-patients with depression receiving antidepressive pharmacological treatment referred for ECT were investigated with the Montgomery–Asberg Depression Rating Scale (MADRS) and a broad neuropsychological test battery within 1 week before and after ECT. The assessments were repeated 6 and 12 months after baseline in 10 and seven of these patients, respectively. Hippocampal volumes were measured on all four occasions with 3 Tesla MRI.ResultsHippocampal volume returned to baseline during the follow-up period of 6 months. Neither the significant antidepressant effect nor the significant transient decrease in executive and verbal episodic memory tests after ECT could be related to changes in hippocampal volume. No persistent cognitive side effects were observed 1 year after ECT.ConclusionThe immediate increase in hippocampal volume after ECT is reversible and is not related to clinical or cognitive outcome.

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The aim of this study was to examine whether cognitive test performance alone could distinguish patients with dementia ofAlzheimer type (DAT) from those with frontotemporal dementia (FTD). Scores from three neuropsychological tests were used as discriminating variables in 28 cases with postmortem verified diagnoses. The selected tests measured verbal ability, visuospatial ability and verbal memory. Eighty-nine per cent of the sample was correctly classified by discriminant analysis. Evaluating the ability of the obtained discriminant function to differentiate between groups of DAT and FTD in a new, clinically diagnosed sample of 38 cases yielded an overall success rate of 84%. The results suggest that cognitive tests may be helpful for differential diagnosis in the context of a neuropsychiatric examination.KEY WORDS-Dementia of Alzheimer type, frontotemporal dementia, neuropsychological tests, discriminant analysis, postmortem examination, clinical diagnosis, regional cerebral blood flow.

ContextPatients with craniopharyngioma (CP) and hypothalamic lesions (HL) have cognitive deficits. Which neural pathways are affected is unknown.ObjectiveTo determine whether there is a relationship between microstructural white matter (WM) alterations detected with diffusion tensor imaging (DTI) and cognition in adults with childhood-onset CP.DesignA cross-sectional study with a median follow-up time of 22 (6–49) years after operation.SettingThe South Medical Region of Sweden (2.5 million inhabitants).ParticipantsIncluded were 41 patients (24 women, ≥17 years) surgically treated for childhood-onset CP between 1958–2010 and 32 controls with similar age and gender distributions. HL was found in 23 patients.Main outcome measuresSubjects performed cognitive tests and magnetic resonance imaging, and images were analyzed using DTI of uncinate fasciculus, fornix, cingulum, hippocampus and hypothalamus as well as hippocampal volumetry.ResultsRight uncinate fasciculus was significantly altered (P ≤ 0.01). Microstructural WM alterations in left ventral cingulum were significantly associated with worse performance in visual episodic memory, explaining approximately 50% of the variation. Alterations in dorsal cingulum were associated with worse performance in immediate, delayed recall and recognition, explaining 26–38% of the variation, and with visuospatial ability and executive function, explaining 19–29%. Patients who had smaller hippocampal volume had worse general knowledge (P = 0.028), and microstructural WM alterations in hippocampus were associated with a decline in general knowledge and episodic visual memory.ConclusionsA structure to function relationship is suggested between microstructural WM alterations in cingulum and in hippocampus with cognitive deficits in CP.