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Brain Anatomic Effects of Electroconvulsive Therapy A Prospective Magnetic Resonance Imaging Study

C. Edward Coffey, MD; Richard D. Weiner, MD, PhD; William T. Djang, MD; Gary S. Figiel, MD; Sheryl A. R. Soady, RN; Linda J. Patterson; Peter D. Holt, MD; Charles E. Spritzer, MD; William E. Wilkinson, PhD
Arch Gen Psychiatry. 1991;48(11):1013-1021. doi:10.1001/archpsyc.1991.01810350053008.
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• 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.

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