MRI T ₂ relaxometry of brain regions and cognitive dysfunction following electroconvulsive therapy

Abstract

Background:Although electroconvulsive therapy (ECT) causes no structural brain damage, recent studies reported altered brain perfusion acutely following ECT. This is in keeping with brain edema which was noted in animal experiments following electroconvulsive shock.Aim:This study examined alteration in magnetic resonance imaging (MRI) T2 relaxation time, a measure of brain edema, and its relation to therapeutic efficacy, orientation and memory impairment with ECT.Materials and Methods:Fifteen drug-naive consenting patients of major depressive disorder with melancholia (DSM-IV) received ECT as first-line treatment. MRI scans were done before the first ECT and at 2 hours after the second ECT. T2 relaxation time was measured bilaterally in thalamus, hippocampus, medial temporal lobes and dorsolateral frontal cortex by a blind rater.Results:Depression scores and memory scores were reduced significantly both after the second and fifth ECT. There was no change in T2 relaxation time after second ECT.Conclusion:The finding suggests that ECT does not produce demonstrable change acutely in brain parenchyma detectable by MRI scans.

Grey matter volume increase following electroconvulsive therapy in patients with late life depression: a longitudinal MRI study

“…8,56 However, our data cannot exclude alterations in water con tent, as we did not assess T 2 relaxation time following ECT. [47][48][49] Strikingly, the grey matter volume effects that we found in el derly patients were all in the proximity of spaces containing cerebrospinal fluid (i.e., lateral ventricle, choroid fissure, syl vian fissure).…”

Hippocampal volume in relation to clinical and cognitive outcome after electroconvulsive therapy in depression

“…Kunigiri et al. , detected no increase in T2 relaxation time (corresponding to water content) in the hippocampus after ECT, suggesting that hippocampal oedema does not result from ECT.…”

Relationship Between Hippocampal Volume, Serum BDNF, and Depression Severity Following Electroconvulsive Therapy in Late-Life Depression

“…Although early preclinical research has demonstrated that postictal dendritic swelling could be reversible (Hesse and Teyler, 1976), and the transient intra-ictal breach in the blood-brain barrier (Andrade and Bolwig, 2014) might facilitate local swelling, there is evidence suggesting that edema is unlikely to be the primary cause of the observed volume changes (Kunigiri et al, 2007;Szabo et al, 2007;Nordanskog et al, 2010;Jorgensen et al, 2015).…”