Mechanisms of Action of ECT: New Review From Romania


Out on PubMed, from authors in Romania, is this review:

Neurobiological mechanisms and therapeutic impact of electroconvulsive therapy (ECT).

Cojocaru AM, Vasile AI, Trifu SC.Rom J Morphol Embryol. 2024 Jan-Mar;65(1):13-17. doi: 10.47162/RJME.65.1.02.PMID: 38527979



The abstract is copied below:

Electroconvulsive therapy (ECT) is an efficient therapeutic resource for psycho-pharmacotherapeutic resistant forms of depression. ECT is a form of electrical brain stimulation involving the induction of a controlled seizure, clinically similar to an epileptic seizure, that is initiated in the prefrontal region of the brain and spreads to the cortex and subcortex, including the diencephalic structures. This is achieved by creating a transcranial electric field and synchronously depolarizing neuronal membranes. The mechanisms of action of ECT are not yet fully understood, but several hypotheses have been proposed to explain how it affects the brain: neurotransmitter changes, neuroplasticity, network connectivity, endocrine system regulation and changes in regional cerebral blood flow and regional metabolism.

The review is here.

And fron the text:



This is a surprisingly well-written article; the introductory paragraphs, the description of the ECT procedure, and the side effects review are almost completely accurate. It is worth reading in full, just for that.
The review of mechanisms of action of ECT is good, but not comprehensive, as it could not be expected to be, with only 34 references.
Who knew that such an ECT review would appear in The Romanian Journal of Morphology and Embryology ?
Kudos to these authors for their contribution to the ECT literature. IMO, the article is good enough to recommend as a generic introduction to ECT. Do other blog readers agree?

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