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ECT: Its Brain Enabling EffectsA Review of Electroconvulsive Therapy–Induced Structural Brain Plasticity

Bouckaert, Filip MD*; Sienaert, Pascal MD, PhD*; Obbels, Jasmien MSc*; Dols, Annemieke MD, PhD; Vandenbulcke, Mathieu MD, PhD*; Stek, Max MD, PhD; Bolwig, Tom MD, PhD

doi: 10.1097/YCT.0000000000000129
Invited Reviews

Background Since the past 2 decades, new evidence for brain plasticity has caused a shift in both preclinical and clinical ECT research from falsifying the “brain damage hypothesis” toward exploring ECT’s enabling brain (neuro)plasticity effects.

Methods By reviewing the available animal and human literature, we examined the theory that seizure-induced structural changes are crucial for the therapeutic efficacy of ECT.

Results Both animal and human studies suggest electroconvulsive stimulation/electroconvulsive therapy (ECT)-related neuroplasticity (neurogenesis, synaptogenesis, angiogenesis, or gliogenesis).

Conclusion It remains unclear whether structural changes might explain the therapeutic efficacy and/or be related to the (transient) learning and memory impairment after ECT. Methods to assess in vivo brain plasticity of patients treated with ECT will be of particular importance for future longitudinal studies to give support to the currently available correlational data.

From the *University Psychiatric Center KU Leuven, Leuven, Belgium; †VUmc Amsterdam/GGZinGeest, Amsterdam, the Netherlands and ‡Institute of Neuropsychiatry, Copenhagen, Denmark.

Received for publication January 3, 2014; accepted March 6, 2014.

Reprints: Filip Bouckaert, MD, University Psychiatric Center KU Leuven, Leuvensesteenweg 517, 3070 Kortenberg (e-mail:

The authors have no conflicts of interest or financial disclosures to report.

© 2014 by Lippincott Williams & Wilkins