Changes in the Blood-brain Barrier During Maintenance ECT in Formerly Depressed Patients

Primary hypothesis

• The BBB permeability to Gadovist (measured as Ki) temporarily increases in the right and left hippocampus (HC) after a single ECT.

Secondary hypothesises

• The volume of the right and left HC increases after a single ECT and the volume increase is positively correlated with the BBB permeability
• A larger post-ECT increase in systolic blood pressure correlates with a larger increase in BBB permeability in the right and left HC.
• A larger increase in serum S100-B compared to baseline values is correlated with increased BBB permeability in the right and left HC.

Inclusion criteria

• We will include patients (age 18-75) currently treated with a series of ECT or maintenance ECT referred to the treatment due to moderate to severe depression according to ICD-10.

Exclusion criteria

• Schizophrenia
• Psychotic symptoms
• Any substance use (other than cigarette smoking and alcohol consumption within the recommendations of the Danish National Health Authority) within the last 3 months
• Risk of suicide making transport or participation in the study hazardous
• Claustrophobia or severe restlessness
• Contraindications to DCE-MRI (e.g., metallic implants, increased body temperature, reduced kidney function (estimated Global Filtration Rate (eGFR) of <40 ml/min/1.73 m2), pregnancy)
• Somatic illness potentially confounding results (e.g., any central nervous system diseases or cancers)
• Lack of consent to being informed of potential medically important findings on MRI or blood tests