The Neurobiology of ECT: New Review of Mechanisms of Action From Investigators in the Low Countries

Out on PubMed, from researchers in Belgium and The Netherlands, is this review:


Reviewing the neurobiology of electroconvulsive therapy on a micro- meso- and macro-level.

Belge JB, Mulders P, Van Diermen L, Sienaert P, Sabbe B, Abbott CC, Tendolkar I, Schrijvers D, van Eijndhoven P.Prog Neuropsychopharmacol Biol Psychiatry. 2023 Jun 16:110809. doi: 10.1016/j.pnpbp.2023.110809. Online ahead of print.PMID: 37331685 Review.




The abstract is copied below:

Background: Electroconvulsive therapy (ECT) remains the one of the most effective of biological antidepressant interventions. However, the exact neurobiological mechanisms underlying the efficacy of ECT remain unclear. A gap in the literature is the lack of multimodal research that attempts to integrate findings at different biological levels of analysis METHODS: We searched the PubMed database for relevant studies. We review biological studies of ECT in depression on a micro- (molecular), meso- (structural) and macro- (network) level.

Results: ECT impacts both peripheral and central inflammatory processes, triggers neuroplastic mechanisms and modulates large scale neural network connectivity.

Conclusions: Integrating this vast body of existing evidence, we are tempted to speculate that ECT may have neuroplastic effects resulting in the modulation of connectivity between and among specific large-scale networks that are altered in depression. These effects could be mediated by the immunomodulatory properties of the treatment. A better understanding of the complex interactions between the micro-, meso- and macro- level might further specify the mechanisms of action of ECT.

Keywords: Brain volumes; Electroconvulsive therapy; Inflammatory cytokines; Large-scale network connectivity; MDD.

And from the text:







This is a comprehensive review of the mechanism of action of ECT, with 279 references.

While I do not have access to the full text of this journal via my library, I think you will get the gist from the above excerpts.

Perhaps a future classic with the best summary of of knowledge base of the neurobiology of ECT to date?

Kudos to these authors for taking on this monumental task. Looking forward to a close read of the full article...


Comments

Post a Comment

Popular posts from this blog

ECT plus Antidepressants: a Review

Out on PubMed, from researchers in Rotterdam, The Netherlands, is this review: Influence of an adjuvant antidepressant on the efficacy of  electroconvulsive  therapy: A systematic review and meta-analysis. Pluijms EM, Kamperman AM, Hoogendijk WJ, Birkenhäger TK, van den Broek WW. Aust N Z J Psychiatry. 2020 Sep 8:4867420952543. doi: 10.1177/0004867420952543. Online ahead of print. PMID:  32900217 Here is the "Conclusion" section from the text: Our results suggest that an adjuvant antidepressant enhances the efficacy of ECT in patients with major depression. Although the included studies had some methodological limitations, effect sizes were consistently small to moderate. We speculate that modern-day controlled trials using adequately dosed TCAs and MAOIs will most likely result in larger effect sizes. From a clinical point of view, we prefer an adjuvant TCA to an adjuvant MAOI, since TCAs are generally safe to use with ECT ( American Psychiatric Association, 2001 ; ...
Read more

Clinical Phenotype of Behavioral-Variant Frontotemporal Dementia Reversed by ECT: A Case Report

Image
Out on PubMed, from authors in Germany, is this case report and literature review: Clinical Phenotype of Behavioral-Variant Frontotemporal Dementia Reversed by  ECT : A Case Report. Breitling B, Bartels C, Lange C, Bouter C, Falk HS, Wiltfang J, Zilles-Wegner D, Besse M. Neuropsychobiology. 2024 Dec 2:1-12. doi: 10.1159/000541668. Online ahead of print. PMID:  39622206 The abstract is copied below: Introduction: Diagnosis of frontotemporal dementia (FTD) remains difficult even in the presence of core clinical and imaging features. Furthermore, disease-modifying treatments are lacking. Case presentation: Here, we report a case of a patient with clinical and imaging features of FTD. Electroconvulsive therapy (ECT) was used to target affective and catatonic symptoms. After ECT, the patient showed improvements not only in affective symptoms but also in cognitive domains, leading to a marked improvement in the patient's level of functioning. Conclusion: Against the background of di...
Read more

Early Use of the Name "ECT"- Sacklers in 1949

Image
 "Classics in ECT" brings you this study from Creedmore State Hospital in 1949: Nonconvulsive biochemotherapy with histamine and electric convulsive therapy; a comparative study on hospitalized psychotics with a control  ECT  series. SACKLER AM, SACKLER MD, SACKLER RR. J Nerv Ment Dis. 1949 Sep;110(3):185-97. doi: 10.1097/00005053-194911030-00001. PMID:  18138865 The pdf is here . I originally choose this article as the earliest in PubMed to use the name, "ECT," although it also uses "electric [sic] convulsive therapy."  The very first PubMed "ECT" citation is from 1947, but it is written "E.C.T." and also reports a complication, so we prefer this one. Nomenclature aside, this turns out to be an interesting read, with what would now be considered a somewhat bizarre study comparing histamine therapy with ECT. Among the interesting details are the inclusion of a couple of patients with postpartum psychosis and the observation that longer ...
Read more