Brain anatomic effects of electroconvulsive therapy. A prospective magnetic resonance imaging study.
To determine prospectively whether electroconvulsive therapy (ECT) produces structural brain changes, 35 inpatients with depression underwent magnetic resonance imaging before and twice after (at 2 to 3 days and at 6 months) completion of a course of brief-pulse, bilateral ECT. The magnetic resonance images were analyzed blindly for evidence of changes in brain structure using two approaches: measurement of regional brain volumes and a pairwise global comparison. Structural brain abnormalities were present in many patients before ECT. The course of ECT produced no acute or delayed (6-month) change in brain structure as measured by alterations of the total volumes of the lateral ventricles, the third ventricle, the frontal lobes, the temporal lobes, or the amygdala-hippocampal complex. In five subjects, the pairwise global comparisons revealed an apparent increase in subcortical hyperintensity, most likely secondary to progression of ongoing cerebrovascular disease during follow-up. Our results confirm and extend previous imaging studies that also found no relationship between ECT and brain damage.
Coffey
C E
CE
Department of Psychiatry, Duke University Medical Center, Durham, NC.
Weiner
R D
RD
Djang
W T
WT
Figiel
G S
GS
Soady
S A
SA
Patterson
L J
LJ
Holt
P D
PD
Spritzer
C E
CE
Wilkinson
W E
WE
D000679:Amygdala / Q000033:anatomy & histology; D001921:Brain / Q000033:anatomy & histology* / Q000473:pathology; D002552:Cerebral Ventricles / Q000033:anatomy & histology; D002561:Cerebrovascular Disorders / Q000473:pathology; D003866:Depressive Disorder / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D005260:Female; D006624:Hippocampus / Q000033:anatomy & histology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies