How does electroconvulsive therapy work? Theories on its mechanism

Canadian Journal of Psychiatry

Volumn 56, Issue 1, 2011, Pages 13-18

  Bolwig, Tom G ^a  

^a Mental Health Services CPH   (Denmark)

Author keywords

Electroconvulsive therapy; Hippocampus; Hypothalamus; Mechanism; Melancholic depression; Neurogenesis; Seizures; Theory

Indexed keywords

ANTIDEPRESSANT AGENT; ARGIPRESSIN; BRAIN DERIVED NEUROTROPHIC FACTOR; NEUROPEPTIDE Y;

CATATONIA; COGNITIVE DEFECT; DELIRIUM; DIENCEPHALON; ELECTROCONVULSIVE THERAPY; ELECTROENCEPHALOGRAM; GRAND MAL SEIZURE; HUMAN; MANIA; MELANCHOLIA; NEUROENDOCRINE DISEASE; NUCLEAR MAGNETIC RESONANCE IMAGING; PSYCHOSIS; PSYCHOTHERAPY; REVIEW; SCHIZOPHRENIA; TRANSCRANIAL MAGNETIC STIMULATION;

EID: 79951606263     PISSN: 07067437     EISSN: 14970015     Source Type: Journal    
DOI: 10.1177/070674371105600104     Document Type: Review

References (57)

1. UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and metaanalysis. Lancet. 2003:361:799-808.
2. Pagnin D, de Queiros V, Pini S, et al. Efficacy of ECT in depression: a meta-analytical review. J ECT. 2004;20:13-20. (Pubitemid 38488810)
3. Kho KH, van Wreeswijk MF, Simpson S, et al. A metaanalysis of electroconvulsive therapy: efficacy in depression. J ECT. 2003;19:139-147. (Pubitemid 37087760)
4. Rasmussen KG. Sham electroconvulsive studies in depressive illness: a review of the literature and consideration of the placebo phenomenon in electroconvulsive therapy practise. J ECT. 2009;25(1):54-59.
5. Meduna L. Versuche über die biologische Beinflussung des Ablaufes de Schizophrenie: Camphor und Cardiazolkrampfe. Z Ges Neurol Psychiatr. 1935;152:235-226. German.
6. Meduna L. New methods of medical treatment of schizophrenia. Arch Neurol Psychiatry. 1936;35:36-63.
7. Fink M. Convulsive therapy, theory and practice. New York (NY): Raven Press; 1979.
8. Ewald G. Zur Theorie der Schizophrenie und der Insulinschockbehandling. All Z Psychiatrir. 1939;110. German.
9. Hemphill RE, Walter WG. The treatment of mental disorders by electrically induced convulsions. J Ment Sci. 1942;87:256-275.
10. Abrams R, Taylor MA. Electroconvulsive theory and the diencephalon: a preliminary report. Compr Psychiatry. 1974;15:233-236
11. Abrams R, Taylor MA. Diencephalic stimulation and the effects of ECT in endogenous depression. Br J Psychiatry. 1976;129:482-485.
12. Ottosson J-O. Experimental studies of the mode of action of electroconvulsive therapy. Introduction. Acta Psychiatr Scand Suppl. 1960;35(145):5-6.
13. Michael N. Hypothesized mechanisms and sites of action of electroconvulsive therapy. In: Swartz CM, editor. Electroconvulsive and neuromodulation therapies. New York (NY): Cambridge University Press; 2009. p 75-93.
14. Abrams R. Seizure generalization and the efficacy of unilateral electroconvulsive therapy. Convuls Ther. 1991;2:213-217.
15. Trimble M. Serum prolactin in epilepsy and hysteria. BMJ. 1978;2:1682. (Pubitemid 9061008)
16. McNally KA, Blumenfeld H. Focal network involvement in generalized seizures: new insights from electroconvulsive therapy. Epilepsy Behav. 2004;5:3-12. (Pubitemid 38937057)
17. Eranti S, Mogg A, Pluck G, et al. A randomized, controlled trial with 6-month follow-up of repetitive transcranial magnetic stimulation and electroconvulsive therapy for severe depression. Am J Psychiatry. 2007;164(1):73-81. (Pubitemid 46154785)
18. George MS, Lisanby SH, Avery D, et al. Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial. Arch Gen Psychiatry. 2010;67(5):507-516.
19. Bajbouj M, Merkl A, Schlaepfer TE, et al. Two-year outcome of vagus nerve stimulation in treatment-resistant depression. J Clin Psychopharmacol. 2010;30(3):273-281.
20. Taylor MA, Fink M. Melancholia. The diagnosis, pathophysiology and treatment of depressive illness. Cambridge (GB): Cambridge University Press; 2006.
21. Sapolsky R. Clucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Arch Gen Psychiatry. 2000;57:925-934.
22. Fink M, Ottosson J-O. A theory of convulsive therapy in endogenous depression: significance of hypothalamic functions. Psychiatry Res. 1980;2:49-61. (Pubitemid 10100669)
23. Öhman R, Wålinder J, Balldin J, et al. Prolactin response to electroconvulsive therapy. Lancet. 1976;2:936-937.
24. Allen JP, Denney D, Kendell JW, et al. Corticotropin release during ECT in man. Am J Psychiatry. 1974;131:1225-1228.
25. Herman JP, Schäfer KH, Sladek CD, et al. Chronic electroconvulsive shock treatment elicits up-regulation of CRF and AVP mRNA in select populations of neuroendocrine neurons. Brain Res. 1989;501(2):235-246. (Pubitemid 19259630)
26. Smith JE, Williams K, Burkett S, et al. Oxytocin and vasopressin responses to ECT. Psychiatry Res. 1990;32:201-202 (Pubitemid 20178408)
27. Sorensen PS, Hammer M, Bolwig TG. Vasopressin release during electroconvulsive therapy. Psychoneuroendocrinology. 1982;7:303-308. (Pubitemid 13137514)
28. Widerlöv E, Ekman R, Jensen L, et al. Arginine vasopressin, but not corticotropin releasing factor, is a potent stimulator of adrenecorticotropic hormone following electroconvulsive treatment. J Neural Transm. 1989;75:101-109. (Pubitemid 19033928)
29. Redrobe JP, Dumont Y, Quirion R. Neuropeptide Y (NPY) and depression: from animal studies to the human condition. Life Sci. 2002;71:2921-2937. (Pubitemid 35221402)
30. Heilig M, Zachrisson O, Thorsell A, et al. Decreased cerebrospinal fluid neuropeptide (NPY) in patients with treatment refractory unipolar major depression: preliminary evidence for association with preproNPY gene polymorphism. J Psychiatr Res. 2004;38:113-121. (Pubitemid 38134451)
31. Mathé AA. Neuropeptides and electroconvulsive treatment. J ECT. 199;15:1-15.
32. Nikish G, Mathé AA. CSF monoamine metabolites and neuropeptides in depressed patients before and after electroconvulsive therapy. Eur Psychiatry. 2008;23:356-359.
33. Fink M. Neuroendocrine predictors of electroconvulsive therapy outcome. Dexamethasone suppression test and prolactin. Ann N Y Acad Sci. 1986;462:30-36.
34. Yuuki N, Ida I, Oshima A, et al. HPA axis normalization, estimated by DEX/CRH test, but less alteration on cerebral glucose metabolism in depressed patients receiving ECT after medication treatment failures. Acta Psychiatr Scand. 2005;112:257-265. (Pubitemid 41382731)
35. Takano H, Motohashi N, Uema T, et al. Changes in regional cerebral blood flow during acute electroconvulsive therapy: positron emission tomographic study. Br J Psychiatry. 2007;190:63-68. (Pubitemid 46121503)
36. Garlow SJ, Musselman DI, Nemeroff CB. The neurochemistry of mood disorders: clinical studies. In: Charney DS, Nestler EJ, Bunney BS, editors. Neurobiology of mental illness. New York (NY): Oxford University Press; 1999. p 349-364.
37. Fink M, Taylor MA. Electroconvulsive therapy: evidence and challenges. JAMA. 2007;298(3):330-332.
38. Volavka J, Feldstein S, Abrams R, et al. EEG and clinical change after bilateral and unilateral electroconvulsive therapy. Electroeceph Clin Neurophysiol. 1972;32:631-639.
39. Fuster JM. The prefrontal cortex - an update: time is of the essence. Neuron. 2001;30(2):319-333. (Pubitemid 32536780)
40. Gray JR, Braver TS, Raichle ME. Integration of emotion and cognition in the lateral prefrontal cortex. Proc Natl Acad Sci. 2002;99(6):4115-4120. (Pubitemid 34252238)
41. Sheline YI, Gado MH, Kraemer HC. Untreated depression and hippocampal volume loss. Am J Psychiatry. 2003;160:1516-1518. (Pubitemid 41070930)
42. Videbech P, Ravnkilde B. Hippocampal volume and depression: a metaanalysis of MR studies. Am J Psychiatry. 2004;161:1957-1966. (Pubitemid 39441394)
43. Nordanskog P, Dahlstrand U, Larsson EM, et al. Increase in hippocampal volume after electroconvulsive therapy in patients with depression: a volumetric magnetic resonance imaging study. J ECT. 2010;26(1):62-67.
44. Madsen TM, Treschow A, Bengzon J, et al. Increased neurogenesis in a model of electroconvulsive therapy. Biol Psychiatry. 2000;47:1043-1049. (Pubitemid 30336212)
45. Bolwig TG, Madsen TM. Electroconvulsive therapy in melancholia: the role of hippocampal neurogenesis. Acta Psychiatr Scand Suppl. 2007;433:130-135. (Pubitemid 46114848)
46. Perera TD, Coplan JD, Lisanby SH, et al. Antidepressant-induced neurogenesis in the hippocampus of adult non-human primates. J Neurosci. 2007;27:4894-4901. (Pubitemid 46699055)
47. Carroll B. The dexamethasone suppression test for melancholia. Br J Psychiatry. 1982:140:292-304. (Pubitemid 12184534)
48. Chen F, Madsen TM, Wegener G, et al. Repeated electroconvulsive seizures increase the total number of synapses in adult male rat hippocampus. Eur Neuropsychopharmacol. 2009;19(5):329-338.
49. Jørgensen OS, Bolwig TG. Synaptic proteins after electroconvulsive stimulation. Science. 1979;205:705-707. (Pubitemid 9253861)
50. Bolwig TG, Jørgensen OS. Synaptic proteins after electroconvulsive stimulation: reversibility and regional differences in the brain. Acta Psychiatr Scand. 1980;62:486-493. (Pubitemid 11195851)
51. Sapolsky RM. Depression, antidepressants, and the shrinkring hippocampus. Proc Natl Acad Sci. 2001;98(22):12320-12322.
52. Hellsten J, Wennström M, Mohapel P, et al. Electroconvulsive seizures increase hippocampal neurogenesis after chronic corticosterone treatment. Eur J Neurosci. 2002;16:283-290. (Pubitemid 36160248)
53. Malberg J, Eisch AJ, Nestler EJ, et al. Chronic antidepressant treatment increases neurogenesis in adult hippocampus. J Neurosci. 2000;20:9104-9110. (Pubitemid 32042912)
54. Altar CA, Laeng P, Jurata LW, et al. Electroconvulsive seizures regulate gene expression of distinct neurotrophic sinaling pathways. J Neurosci. 2004;24(11):2667-2677. (Pubitemid 38380943)
55. Jansson L, Wennström M, Johanson A, et al. Glial cell activation in response to electroconvulsive seizures. Prog Neuropsychopharmacol Biol Psychiatry. 2009;33(7):1119-1128.
56. Windle RJ, Shanks N, Lightman SL, et al. Central oxytocin administration reduces stress-induced corticosterone release and anxiety behavior in rats. Endocrinology. 1997:138:2829-2834. (Pubitemid 27258513)
57. Chou TC, Scammell JJ, Gooley SE, et al. Critical role of dorsomedial hypothalamic nucleus in a wide range of behavioural circadian rhythms. J Neurosci. 2003;23:10691-10702. (Pubitemid 37485283)