Bradgate Mental Health Unit, Leicester, UK.
Indian J Psychiatry. 2007 Jul;49(3):195-9. doi: 10.4103/0019-5545.37321.
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.
This study examined alteration in magnetic resonance imaging (MRI) T(2) relaxation time, a measure of brain edema, and its relation to therapeutic efficacy, orientation and memory impairment with ECT.
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. T(2) relaxation time was measured bilaterally in thalamus, hippocampus, medial temporal lobes and dorsolateral frontal cortex by a blind rater.
Depression scores and memory scores were reduced significantly both after the second and fifth ECT. There was no change in T(2) relaxation time after second ECT.
The finding suggests that ECT does not produce demonstrable change acutely in brain parenchyma detectable by MRI scans.
尽管电抽搐治疗(ECT)不会造成结构性脑损伤,但最近的研究报告称,ECT 后会出现急性脑灌注改变。这与动物实验中电惊厥后观察到的脑水肿一致。
本研究探讨了磁共振成像(MRI)T2 弛豫时间的变化,这是脑水肿的一种测量方法,以及其与 ECT 的治疗效果、定向和记忆障碍的关系。
15 名符合 DSM-IV 标准的、未经药物治疗的、伴有忧郁的重度抑郁症患者接受 ECT 作为一线治疗。在第一次 ECT 之前和第二次 ECT 后 2 小时进行 MRI 扫描。由一位盲法评分者双侧测量丘脑、海马体、内侧颞叶和额上回的 T2 弛豫时间。
第二次和第五次 ECT 后抑郁评分和记忆评分均显著降低。第二次 ECT 后 T2 弛豫时间无变化。
该发现表明 ECT 不会在 MRI 扫描中急性检测到脑实质的可证明的变化。