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November 1991

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

Author Affiliations

From the Departments of Psychiatry (Drs Coffey, Weiner, Figiel, and Holt and Mss Soady and Patterson), Medicine (Neurology) (Dr Coffey), Radiology (Drs Djang and Spritzer), and Community and Family Medicine (Biometry) (Dr Wilkinson), Duke University Medical Center, Durham, NC, and the Durham Veterans Affairs Hospital (Dr Weiner).

Arch Gen Psychiatry. 1991;48(11):1013-1021. doi:10.1001/archpsyc.1991.01810350053008

• 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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