Neurobiological mechanisms of ECT and TMS treatment in depression: study protocol of a multimodal magnetic resonance investigation

Table 1 Variable overview

	Timepoints (TP) for analyses	TP1		TP2	TP3	TP4	TP5
	Timepoints relative to treatment	Baseline, before treatment		During treatment		After treatment
	Timeframe for each test	< 7 d of first ECT/TMS	1–2 h before first ECT/TMS	1–2 h after first ECT/TMS	before 7th ECT/11th TMS	7–14 d after last ECT/TMS	6 mo after ECT/TMS series
Clinical assessments ^c	Clinical examination	x
ECT- stimulus specific measures ^b	EEG, pulse width, charge, amplitude, frequency, pulse train duration, seizure duration, electrode placement and reorientation time		x		x
ECT- stimulus specific measures ^b	Current and concomitant medication	x			x	x	x
Symptom severity ^c	MADRS [47]	x			x	x	x
	BDI [48]	x			x	x	x
	CGI [49]	x			x	x	x
	EMQ [50]	x			x	x	x
	MMSE [51]
Radiology	MRI: T1, T2, MRS, ASL, DWI, rsfMRI		x	x	x	x	x
Neurocognitive assessments aligned with GEMRIC recommendation	1. RAVLT [52, 53]	x				x	x
	2. Phonemic Fluency [54]	x				x	x
	3. Semantic Fluency [54]	x				x	x
	4. SDMT [55]	x				x	x
	5. TMT A + B [54]	x				x	x
	7. DSB [55]	x				x	x
	8. AMT [56]	x				x	x
	9. MoCa version 7.1 [57]	x				x	x
	10. NART [58]	x				x	x
	11. QIDS-SR 16 [59]	x				x	x
Study specific neurocognitive assessments	1.VAMS^a,^c [60]	x				x	x
	3. Spatial navigation: Memory retrieval task [61, 62], Four Mountain [63], Sea Hero [64]	x				x	x
	4. RCFT [65]	x				x	x
	5. CWIT [54]	x				x	x
	6. PDQ-5 [66, 67] ^c	x				x	x
	7. ECCA [68] ^c	x				x	x
Brain laterality, cognitive control	iDichotic [69, 70]	x				x	x
Blood samples	Serum, EDTA, PAX-gen		x		x	x	x
Actigraphy	Empatica 4 [71] ^b	x		x	x	x	x

Abbreviations: TP Timepoint, MADRS Montgomery Åsberg Depression Rating Scale, BDI Beck Inventory test, CGI Global Impression Scale, EMQ Everyday Memory Questionary, MMSE Mini Mental Status, RAVLT Rey Auditory Verbal Learning Test, F-A-S Phonemic Fluency, SDMT Symbol Digit Modality Test, TMT Trail Making Test, DSB Digit Span Backwards, AMT Autobiographical Memory Test, NART National Adult Reading Test, QIDS-SR 16 Quick Inventory of Depressive Symptomatology (16-item) (Self-Report), VAMS Visual Analog Mood Scale, RCFT Rey-Osterrieth Complex Figure Test, CWIT Color Word Interference Test, EEG electroencephalografy, PDQ-5 Perceived Deficits Questionary – Depression 5-item, ECCA Electroconvulsive Cognitive Assessment, iDichotic Dichotic listening, EDTA Ethylene Diamine-Tetra-acetic Acid, PAX-gen PAXgene Blood RNA tube, Empatica 4 Actigraphy with a wristband; MRS Magnetic Resonance Spectroscopy, ASL Arterial Spin Labeling, DWI Diffusion Weighted Imaging, rsfMRI Resting state functional magnetic resonance imaging
^aRepeated before and after each treatment
^bRepeated at each ECT treatment, TMS patients follow the same timepoints as the ECT patients
^cWill not be assessed for healthy controls

ISSN: 1471-244X