Severity of subcortical gray matter hyperintensity predicts ECT response in geriatric depression

Objective: To determine the effect of subcortical white and gray matter les ions on ECT outcome. Method: 41 geriatric psychiatric inpatients underwent an MRI scan during their ECT work-up. Periventricular, deep white matter, a nd subcortical gray matter hyperintensities were graded. The associations o f low versus high hyperintensity ratings and symptom scores, Clinical Globa l Impression severity (CGS) ratings, Montgomery-Asberg Depression Scale sco re, and number of treatments were examined using t-tests and repeated measu res ANOVA. Results: Patients with more severe subcortical gray hyperintensi ties (SCG) had significantly less improvement as measured by CGS ratings. C onclusions: SCG severity may limit the improvement of patients receiving EC T. Further studies are needed to examine differences based on electrode pla cement and to determine whether patients with severe SCG may require more E CT treatments in an index course.