Abstract
OBJECTIVE: The main purpose of this review was to synthesise evidence on ECT's effects on brain's structure.
METHOD: A systematic literature review of longitudinal studies of depressed patients treated with ECT using magnetic resonance imaging (MRI) and meta-analysis of ECT's effect on hippocampal volume.
RESULTS: Thirty-two studies with 467 patients and 285 controls were included. The MRI studies did not find any evidence of ECT-related brain damage. All but one of the newer MRI volumetric studies found ECT-induced volume increases in certain brain areas, most consistently in hippocampus. Meta-analysis of effect of ECT on hippocampal volume yielded pooled effect size: g = 0.39 (95% CI = 0.18-0.61) for the right hippocampus and g = 0.31 (95% CI = 0.09-0.53) for the left. The DTI studies point to an ECT-induced increase in the integrity of white matter pathways in the frontal and temporal lobes. The results of correlations between volume increases and treatment efficacy were inconsistent.
CONCLUSION: The MRI studies do not support the hypothesis that ECT causes brain damage; on the contrary, the treatment induces volume increases in fronto-limbic areas. Further studies should explore the relationship between these increases and treatment effect and cognitive side effects.
| Original language | English |
|---|---|
| Journal | Acta Psychiatrica Scandinavica |
| Volume | 138 |
| Issue number | 3 |
| Pages (from-to) | 180-195 |
| Number of pages | 16 |
| ISSN | 0001-690X |
| DOIs | |
| Publication status | Published - Sept 2018 |