An inside look at electroshock.

An inside look at electroshcok

In a "before and after" study of the effects of electroshock therapy on the brain, relying for the first time on magnetic resonance imaging (MRI) technology, researchers found no changes in the brain structure of patients who had completed a course of the controversial treatment.

In addition, say psychiatrist C. Edward Coffey and his colleagues at Duke University Medical Center in Durham, N.C., patients with preexisting brain impairments, such as moderate shrinking of tissue causing enlargement of fluid-filled cavities in the brain, showed no worsening of their condition after electroshock, also known as electroconvulsive therapy (ECT).

The researchers examined nine patients with severe depression referred for their first course of ECT. Subjects received five to 11 ECT treatments, administered three times a week. MRI scans, which provide an accurate three-dimensional picture of structures throughout the brain, were taken before and several days after completion of the series of treatments.

Depression was significantly reduced in all but one of the patients after completing ECT, note the researchers in the June AMERICAN JOURNAL OF PSYCHIATRY. The exception was a woman who became markedly disoriented for about five days after treatment ended; she then became somewhat less depressed and was no longer suicidal. The other eight patients did not complain of persistent memory loss for events in the months preceding ECT, a common side effect of the treatment.

ECT critics charge the treatment has caused permanent brain damage in animals, but definitive studies of brain metabolism and tissue changes during and after electroshock have not been done (SN: 6/22/85. p.389). Coffey and his co-workers say the initial MRI findings need to be confirmed in a larger patient sample followed for a longer time after treatment ends. Future studies, they add, should include patients who have previously undergone ECT.