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Electroconvulsive therapy in patients with late-onset psychoses and structural brain changes
K Botteron1, G S Figiel, C F Zorumski
1Washington University School of Medicine, Department of Psychiatry, St Louis, MO 63110.
Journal of Geriatric Psychiatry and Neurology
|January 1, 1991
Summary
Electroconvulsive therapy (ECT) may be less effective for late-onset psychoses with severe brain changes. Patients with caudate hyperintensities treated with ECT experienced prolonged delirium, suggesting increased risk.
Area of Science:
- Neurology
- Psychiatry
Background:
- Late-onset psychoses require effective treatment options.
- Electroconvulsive therapy (ECT) is a recognized treatment for psychiatric disorders.
Observation:
- Three patients with late-onset psychoses underwent ECT.
- All patients exhibited pre-existing structural brain changes on MRI.
- Two patients with significant structural changes showed no response to ECT.
Findings:
- Caudate hyperintensities were observed in all three patients.
- All patients developed prolonged interictal delirium following ECT.
- Severe structural brain changes correlated with non-response to ECT.
Implications:
- Pre-existing brain abnormalities may predict ECT non-response in late-onset psychoses.
- Caudate hyperintensities might indicate an elevated risk of ECT-induced delirium.
- Further research is needed to refine ECT protocols for patients with structural brain changes.