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Leukoencephalopathy in elderly depressed patients referred for ECT
C E Coffey1, G S Figiel, W T Djang
1Department of Psychiatry, Duke University Medical Center, Durham, NC 27710.
Biological Psychiatry
|June 1, 1988
Summary
Brain imaging revealed subcortical white matter changes (leukoencephalopathy) in 66% of elderly depressed patients undergoing electroconvulsive therapy (ECT). These patients often showed significant improvement with ECT, suggesting a link between brain structure and treatment response.
Area of Science:
- Neuroimaging
- Geriatric Psychiatry
- Neurology
Background:
- Subcortical white matter changes, termed leukoencephalopathy, are observed in elderly patients with depression.
- These changes are often associated with other structural brain abnormalities.
Purpose of the Study:
- To investigate the prevalence of subcortical white matter changes in elderly depressed inpatients referred for electroconvulsive therapy (ECT).
- To explore the association between these changes and treatment response to ECT.
Main Methods:
- Brain magnetic resonance imaging (MRI) and high-resolution computed tomography (CT) were used.
- Patient data included demographics, psychiatric history, and treatment outcomes.
Main Results:
- Leukoencephalopathy was identified in 66% of elderly depressed patients (44/67) referred for ECT.
- These patients frequently exhibited cortical atrophy, enlarged ventricles, and lacunar infarctions.
- Despite treatment resistance to other therapies, 98% of patients with leukoencephalopathy responded well to ECT.
Conclusions:
- Subcortical white matter changes are common in elderly depressed patients undergoing ECT.
- Leukoencephalopathy may be linked to arteriosclerotic disease.
- ECT is an effective treatment for elderly depression, even with significant white matter abnormalities.