Electroconvulsive therapy increases brain volume in major depression: a systematic review and meta-analysis
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Electroconvulsive therapy increases brain volume in major depression : a systematic review and meta-analysis. / Gbyl, K; Videbech, P.
In: Acta Psychiatrica Scandinavica, Vol. 138, No. 3, 2018, p. 180-195.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Electroconvulsive therapy increases brain volume in major depression
T2 - a systematic review and meta-analysis
AU - Gbyl, K
AU - Videbech, P
N1 - © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
U2 - 10.1111/acps.12884
DO - 10.1111/acps.12884
M3 - Review
C2 - 29707778
VL - 138
SP - 180
EP - 195
JO - Acta Psychiatrica Scandinavica
JF - Acta Psychiatrica Scandinavica
SN - 0001-690X
IS - 3
ER -
ID: 218437518