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Subcortical structural changes in ECT-induced delirium.

G S Figiel1, K R Krishnan, P M Doraiswamy

  • 1Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110.

Journal of Geriatric Psychiatry and Neurology
|July 1, 1990
PubMed
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Electroconvulsive therapy (ECT) can cause prolonged delirium in elderly patients. Structural brain changes in the basal ganglia and white matter may predispose individuals to this delirium.

Area of Science:

  • Neuroscience
  • Geriatric Psychiatry
  • Neurology

Background:

  • Electroconvulsive therapy (ECT) is a treatment for severe depression.
  • Delirium can occur as a side effect of medical treatments, including ECT.
  • Previous research suggests basal ganglia and white matter involvement in delirium.

Purpose of the Study:

  • To investigate the incidence of prolonged interictal delirium following ECT in elderly patients.
  • To identify potential neuroanatomical correlates of ECT-induced delirium.

Main Methods:

  • A cohort of 36 elderly depressed patients undergoing ECT was studied.
  • Brain imaging (MRI and CT) was performed on patients who developed delirium.
  • Clinical assessment for prolonged interictal delirium was conducted.

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Main Results:

  • 17% (6/36) of elderly patients developed prolonged interictal delirium after ECT.
  • All six patients with delirium showed structural changes in the basal ganglia and white matter on brain imaging.
  • Findings align with previous research implicating these brain regions in delirium.

Conclusions:

  • Structural abnormalities in the basal ganglia and subcortical white matter may predispose elderly patients to interictal delirium during ECT.
  • These findings highlight the importance of neuroimaging in understanding ECT-induced delirium.