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Updated: Jul 14, 2026
A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
Published on: November 13, 2016
Diffusion weighted MRI in the early phase after electroconvulsive therapy
Kristina Szabo1, Jochen G Hirsch, Martin Krause
1Department of Neurology, Universitätsklinikum Mannheim, University of Heidelberg, Mannheim, Germany. szabo@neuro.ma.uni-heidelberg.de
Abstract:
Although cognitive side effects may occur after electroconvulsive therapy (ECT), no structural brain abnormalities have been detected after ECT with conventional magnetic resonance imaging (MRI). Transient disturbances of memory function are common findings after ECT indicating functional compromise. Diffusion weighted imaging (DWI) has been shown to be sensitive to focal tissue changes associated with compromise of energy metabolism in cerebral ischemia and after prolonged ictal activity. We used conventional MRI and DWI in an exploratory study examining ten patients after treatment with ECT, eight of whom experienced short-lasting memory disturbances. MRI and DWI showed no definite signal abnormalities on qualitative and quantitative analysis. In three patients, equivocal marginal DWI hyperintensity was noted in the hippocampal formation. These findings are in line with previous negative studies using conventional MRI. Higher resolution DWI and serial imaging may be necessary to visualize possible minimal signal changes after ECT.
Insights
Electroconvulsive therapy (ECT) did not reveal structural brain abnormalities on conventional MRI or diffusion-weighted imaging (DWI). Minimal DWI changes in the hippocampus were noted in some patients experiencing memory issues after ECT.
Area of Science:
- Neuroimaging
- Neurology
- Psychiatry
Background:
- Cognitive side effects, particularly memory disturbances, are potential adverse effects of electroconvulsive therapy (ECT).
- Conventional magnetic resonance imaging (MRI) has not detected structural brain abnormalities following ECT.
- Diffusion-weighted imaging (DWI) is sensitive to subtle tissue changes, including those related to energy metabolism compromise.
Purpose of the Study:
- To investigate potential subtle structural brain changes after electroconvulsive therapy (ECT) using conventional MRI and diffusion-weighted imaging (DWI).
- To correlate imaging findings with transient memory disturbances experienced by patients undergoing ECT.
Main Methods:
- An exploratory study involving ten patients treated with ECT.
- Conventional MRI and DWI were performed on all patients.
- Qualitative and quantitative analyses of MRI and DWI data were conducted.
Main Results:
- No definite signal abnormalities were detected on conventional MRI or DWI in the ten patients.
- Eight patients experienced short-lasting memory disturbances post-ECT.
- Equivocal marginal DWI hyperintensity in the hippocampal formation was observed in three patients.
Conclusions:
- Conventional MRI and DWI, as employed in this study, did not reveal significant structural brain abnormalities after ECT.
- The findings align with previous research indicating a lack of detectable structural changes with conventional MRI.
- Higher resolution DWI and serial imaging might be required to detect minimal signal alterations potentially associated with ECT.
