ECT and Cerebral Amyloid: Case Report

Out on Pubmed, from clinicians in The Netherlands, is this case report: 

Successful electroconvulsive therapy for depression in a man with cerebral amyloid angiopathy.

Schurgers G, Arts BMG, Postma AA, de Kort A.BMJ Case Rep. 2021 Feb 5;14(2):e238922. doi: 10.1136/bcr-2020-238922.PMID: 33547125

The pdf is here.

I approached this case report with ennui and some disdain, but ended up being totally impressed with its high quality and sophistication. The clinical care and medical investigations were state of the art; the teaching points are all well taken.

This case adds to the considerable body of evidence that ECT remains safe and effective despite the presence of certain common brain pathologies of aging. The sensible approach used to limit intra-procedural hemodynamic changes in a patient with prior intracerebral hemorrhage is what most practitioners would do.

The discussion in the case report is also excellent, including the fascinating theoretical speculation that ECT might actually have a beneficial effect on cerebral amyloid angiopathy by increasing Aβ elimination.

This case report is definitely worth a full read (~15 minutes).