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Not enough is understood about the structural effects of electroconvulsive therapy (ECT). In a mega-analysis (which integrates individual-participant data), members of an international ECT study group examined prospective MRI data obtained within a week before ECT and 1 to 2 weeks after the final ECT in 328 depressed patients (mean age, 55) treated at 14 sites and at comparable time lapses in 95 controls (mean age, 47).
ECT was very effective, with 63% of patients responding and 47% remitting. In analyses controlling for age, sex, baseline brain volumes, and site, ECT was associated with broadly distributed increases in volumes of cortical and subcortical gray matter, with corresponding decreases in ventricle size; white-matter volume did no…