Clinical Neuroscience of ECT (CNECT)

 Out on PubMed, from authors in China and the US, is this article: Optimizing Electroconvulsive Therapy With E-Field Modeling: A Narrative Review. Ren C, Kung S, Croarkin PE, Opitz A, Forester BP, Hermida AP, Mueller M, Pagali SR, Petrides G, Seiner SJ, Yoon IA, Lapid MI. J ECT. 2025 Jan 24. doi: 10.1097/YCT.0000000000001111. Online ahead of print. PMID:  39853304 The abstract is copied below: Electroconvulsive therapy (ECT) is an effective treatment for severe depression, especially in treatment-resistant cases. However, its potential cognitive side effects necessitate careful dosing to balance therapeutic benefits and cognitive stability. Recent advances in electric field (E-field) modeling offer promising avenues to optimize ECT dosing. This review synthesizes current knowledge on E-field modeling in ECT and explores its clinical applications. It examines the variability in E-field strengths and distributions induced by ECT and their impact on clinical outcomes. Additionall...

 Out on PubMed, from authors in China, is this LTE: Outcomes of  electroconvulsive  therapy in adolescents with a depressive episode (depressive, bipolar disorders): a naturalistic retrospective cohort study. Zhu X, Wu Y, Chen X, Feng Z, Xu J, Zhang L, Chen X, Wang G. Brain Stimul. 2025 Jan 21:S1935-861X(25)00018-X. doi: 10.1016/j.brs.2025.01.016. Online ahead of print. PMID:  39848537 The LTE is here: https://www.sciencedirect.com/science/article/pii/S1935861X2500018X?fr=RR-2&ref=pdf_download&rr=90722a2acba5bf8e And from the text: The main findings of this real-world retrospective study were as follows: ECT treatment is effective for adolescent patients experiencing a depressive episode. Factors influencing the response rate to ECTs include BMI, pretreatment severity of depression, presence of suicidality, and NSSI. Regarding the determination of the optimal number of ECTs, administering more than eight times appears to yield more favorable treatment outcome...

 Out on PubMed, from authors in Hong Kong and Bangladesh, is this review: Therapeutic Approaches to Tackle the Challenge of Depression That Is Resistant to Treatment-A Narrative Review. Rajdoula Rafe M, Waris A, Saha P. Health Sci Rep. 2025 Jan 22;8(1):e70370. doi: 10.1002/hsr2.70370. eCollection 2025 Jan. PMID:  39846041 The abstract is copied below: Background and aims: The lack of therapeutic response characterizes treatment-resistant depression despite undergoing at least two adequate monotherapy trials with medications from distinct pharmacologic classes. The inability to attain remission in patients diagnosed with major depressive disorder (MDD) is a significant issue of concern within public health. Therefore, the management of treatment-resistant depression (TRD) poses significant obstacles for both patients and healthcare professionals. Our goal was to investigate the published literature concerning different options for treatment for TRD, including those that do not ...

 Out on PubMed, from authors in Switzerland, is this review: Alterations in resting-state EEG functional connectivity in patients with major depressive disorder receiving electroconvulsive therapy: A systematic review. Ulrich S, Schneider E, Deuring G, Erni S, Ridder M, Sarlon J, Brühl AB. Neurosci Biobehav Rev. 2025 Jan 17:106017. doi: 10.1016/j.neubiorev.2025.106017. Online ahead of print. PMID:  39828233 The abstract is copied below: Electroconvulsive therapy (ECT) is highly efficacious for the treatment of major depressive disorder (MDD), but its mechanisms still require clarification. Even though depression is associated with alterations in functional connectivity (FC), EEG studies investigating effects of ECT on FC have not been systematically reviewed. Understanding these effects may help to identify the role of functional brain circuits in depression and its remission. This systematic review aimed to synthesize EEG studies investigating FC changes in ECT-treated patien...

 Out on PubMed, from researchers in Finland, is this study: The Recognition and Management of Adverse Effects in Electroconvulsive Therapy: Findings From a Finnish Survey Study. Huoponen SH, Sisa K, Saari T, Taittonen M, Ahlmén-Laiho U. Brain Behav. 2025 Jan;15(1):e70227. doi: 10.1002/brb3.70227. PMID:  39829102   The abstract is copied below: Aim: The aim of the study was to survey the observed incidence of adverse effects (AEs) related to electroconvulsive therapy (ECT) in Finnish neuromodulation units, as well as to explore what medical interventions are used to prevent and treat them in those units. Methods: An electronic survey was conducted among Finnish neuromodulation units at the end of 2022. The survey included 35 questions related to AEs and their prevention and/or treatment in the responding units' ECT patient populations. Results: Our survey reached 19 out of 26 units in Finland, with 17 units completing the full questionnaire. Headache, myalgia and postictal...

 Out on PubMed, from West Coast investigators, is this study: Trajectory of peripheral inflammation during index  ECT  in association with clinical outcomes in treatment-resistant depression. Hough CM, Kruse JL, Espinoza RT, Brooks JO 3rd, Congdon EJ, Norris V, Craske MG, Narr KL. Brain Behav Immun Health. 2024 Dec 15;43:100925. doi: 10.1016/j.bbih.2024.100925. eCollection 2025 Feb. PMID:  39834556 The abstract is copied below: Background: Electroconvulsive therapy (ECT) is a highly efficacious intervention for severe and intractable depression. E vidence suggests ECT provokes an initial acute inflammatory response that subsequently decreases with repeated administration. However, relationships between inflammatory changes and clinical effects are unclear. Improved understanding of these processes may provide critical insight into effective intervention for treatment-resistant depression (TRD). Methods: Plasma inflammatory markers were assessed at pre-treatment (T1),...

 Out on PubMed, from authors in Georgia, is this case report: Individual on Death  Row  Receiving  Electroconvulsive  Therapy (ECT) for Catatonia: A Case Report. Basden BJ, Surya S, Rosenquist PB, McCall WV. J ECT. 2024 Nov 18. doi: 10.1097/YCT.0000000000001082. Online ahead of print. PMID:  39823645 The abstract is copied below: Electroconvulsive therapy (ECT) is underused, logistically challenging for those who are justice-involved, and laced with ethical problems for those on death row. Herein we describe a case of a man without history of long-standing psychiatric illness who, after more than 15 years on death row, was hospitalized for altered mental status. After medical stabilization, the altered mental status persisted. On exam, he displayed signs of catatonic stupor with repetitive non-goal-directed motor activity, repetition of words, rigidity, and negativism, among others. The Bush-Francis Catatonia Rating Scale was found to be 23. Lorazepam was n...

 Out on PubMed, from clinicians in Wales, is this paper: Intravenous Ketamine to Facilitate Transport of Agitated Patients to the  ECT  Clinic. Dean O, Byford-Brooks A, Hannigan K, Saunders D, Gamble W, Kirov G. J ECT. 2024 Nov 26. doi: 10.1097/YCT.0000000000001090. Online ahead of print. PMID:  39589116 The abstract is copied below: Objectives: Electroconvulsive therapy (ECT) can be effective for a variety of psychiatric conditions, including for some patients who are very psychotic or agitated. Transferring such patients from the psychiatric ward to the ECT clinic can pose significant challenges for treating teams, as they try to minimize the use of restraint. Methods: We developed a protocol for safe transfer of such patients using sedation with ketamine. An intravenous cannula is inserted on the ward in a low stimulus environment with gentle supportive holds. Intravenous ketamine is given in a bolus at 0.5-2.0 mg/kg. The patient is transported on a transfer bed t...

 Out on PubMed, from authors in New Jersey and Ohio, is this case report: Electroconvulsive therapy in the treatment of catatonia in a patient with Budd Chiari syndrome: a case report. Abbas M, Noto J, Adams D, Vallesteros R, Bukhari SMA. Neurocase. 2025 Jan 16:1-4. doi: 10.1080/13554794.2024.2446316. Online ahead of print. PMID:  39817652 The abstract is copied below: Catatonia may manifest as an independent entity or as a feature of a neuropsychiatric or medical illness. While electroconvulsive therapy (ECT) is the gold standard treatment for catatonia, it is typically administered if the patient's symptoms fail to respond to benzodiazepines. We describe the case of a 22-year-old male with Budd Chiari induced cirrhosis and no prior psychiatric history, who presented with symptoms of psychosis and hepatic encephalopathy, was treated in the ICU for multi-factorial delirium, developed symptoms of catatonia that failed to respond to lorazepam, ultimately requiring ECT with a fav...

 Out on PubMed, from authors in the USA, is this review: Electroconvulsive therapy in autism spectrum disorders: an update to the literature. Wachtel L, Luccarelli J, Falligant JM, Smith JR. Curr Opin Psychiatry. 2024 Dec 23. doi: 10.1097/YCO.0000000000000985. Online ahead of print. PMID:  39804212 The abstract is copied below: Purpose of review: Over the last quarter century, the clinical evidence surrounding the use of electroconvulsive therapy (ECT) in individuals with autism spectrum disorder (ASD) has expanded. This review provides the most up-to-date findings on the usage of ECT in ASD and discusses these results within the historical context and direct patient care experience. Recent findings: ECT is typically implemented for psychotropic-refractory catatonic, affective, psychotic, and combined pathology for individuals across the lifespan. Although highly stigmatized, ECT is well tolerated, efficacious, and potentially lifesaving for select individuals. A case presenta...

 Out on PubMed, from an international collaboration of authors, is this paper: Early career psychiatrists' perceptions of and training experience in  electroconvulsive  therapy: A cross-sectional survey across Europe. Țăpoi C, Alexander L, de Filippis R, Agorastos A, Almeida D, Bhatia G, Erzin G, Gołębiewska ME, Metaj E, Medved S, Mieze K, Milutinović M, Noël C, Pushko A, Gurrea Salas D, Compaired Sanchez A, Wilkowska A, Wolthusen RPF, Pinto da Costa M. Eur Psychiatry. 2025 Jan 13;67(1):e86. doi: 10.1192/j.eurpsy.2024.1798. PMID:  39801359 The abstract is copied below: Background: Electroconvulsive therapy (ECT) is a safe and effective treatment for several major psychiatric conditions, including treatment-resistant depression, mania, and schizophrenia; nevertheless, its use remains controversial. Despite its availability in some European countries, ECT is still rarely used in others. This study aims to investigate the experiences and attitudes of early career psychi...

Happy 102nd birthday to Max Fink, MD! Max Fink, an icon in our field, is one of the most influential ECT researchers, practitioners and advocates of all time. He has also been a friend and mentor to many of us in the ECT world, and we owe him a great debt of gratitude. Please join me in wishing him all the best today!                                                    Max Fink, October 2024, with Andrea and Charles Kellner

 Out on PubMed, from authors in Japan, is this paper: Approaches for difficult-to-induce-seizures  electroconvulsive  therapy cases (DEC): a Japanese expert consensus. Takekita Y, Suwa T, Yasuda K, Kawashima H, Omori W, Kurimoto N, Tsuboi T, Noda T, Aoki N, Wada K, Inada K, Takebayash M; Expert Consensus Development Working Group; Electroconvulsive Therapy Committee; Japanese Society of General Hospital Psychiatry. Ann Gen Psychiatry. 2025 Jan 12;24(1):2. doi: 10.1186/s12991-024-00543-9. PMID:  39800695   The abstract is copied below: Background: Seizure threshold increases with age and the frequency of electroconvulsive therapy (ECT). Therefore, therapeutic seizures can be difficult to induce, even at maximum stimulus charge with available ECT devices. Such cases are known as difficult-to-induce-seizures electroconvulsive therapy cases (DECs ). However, no clinical guidelines exist for DECs; thus, clinicians often face difficulties determining treatment strateg...