— A small new study gives insight into electroshock therapy, an effective though understood treatment for severe depression, changes the brains of individuals that are blue.
Researchers used functional MRI scans to look at brain activity in nine adults with acute depression before and following electroshock therapy. The investigators found that electroshock, or electroconvulsive therapy (ECT), dampens the connections between distinct areas of the brain in depressed people.
“With our study we were able to verify that there’s hyperconnectivity [in melancholy], and in addition we’re able to demonstrate that treatment removes it,” said study co-author Christian Schwarzbauer, a professor of neuroimaging at the University of Aberdeen in Scotland.
Schwarzbauer said, one explanation might be that they’ve too much internal brain process and cannot deal as well with external stimulus, although it may seem counterintuitive that people who have serious depression, who are frequently also lethargic, would have brains on overdrive.
This study could point to ways to enhance electroshock therapy’s effectiveness and safety, he added. In its 76-year history, the treatment has met with resistance from physicians because of concerns such as memory loss, of its own side effects.
Electroshock therapy is typically used for patients who never have responded to antidepressants or other forms of treatment and are vulnerable to hurting themselves or others.
“I think the reality that now there’s more of an explanation, I think that is assuring to the clinician as well as the patient,” said Jennifer Perrin, who’s a research fellow at the University of Aberdeen and lead author of the study published online March 19 in the Proceedings of the National Academy of Sciences.
For the study, nine severely depressed participants experienced functional MRI scans of the entire brain before and following a streak of electroshock therapy. They received the treatment twice a week until their symptoms, including exhaustion and depression, subsided.
The players received electroshock therapy previously six months or hadn’t responded to antidepressant drugs prior to the study, although four of the patients were taking antipsychotic medications.
The researchers zeroed in on an area in the front of the brain known as the dorsolateral prefrontal cortex. It’d fewer and less intense links using numerous other areas of the brain following electroshock therapy, the scans revealed.
This specific portion of the brain is involved in cognition [believed procedures] social and behavior and continues to be implicated in depression, which means this finding is not surprising, said Tony Tang, an adjunct professor of psychology at Northwestern University. What’s surprising, he said, is that none of the numerous other brain areas which have been associated with depression were discovered to have cut-off lines of communication following electroshock therapy.
“ECT is a somewhat invasive, severe procedure and you see lots of changes in patients, so we’d probably speculate that there would be some kind of prevalent brain connectivity changes,” Tang said. This study “found it to be localized, and I found that to be quite amazing.”
Clinicians produce enough electric current to induce a seizure and, while the patient is under anesthesia, place electrodes on the entire scalp. The therapy is more powerful when electrodes are on either side of the head, in contrast to just one, but unfortunately this also carries greater danger of side effects.
Having electrodes on both sides of the head could be more effective as it activates a more prevalent seizure, but the current findings indicate another chance, Tang said: When clinicians put electrodes merely on a single side of the entire scalp, they usually put them over the correct half of the brain as it is not as dominant (for right-handed individuals). However, according to the study, the dorsolateral prefrontal cortex, in the left side of the brain, could function as crucial area to target.
“Most localized types of stimulation we have attempted so far don’t work as well [as having electrodes on both sides], but this type of study could potentially point to the right way,” Tang said.
Looking at brain links in people with serious depression could help clinicians predict who will relapse after treatment as well as who will take advantage of electroshock therapy, Schwarzbauer suggested. Between 80 percent of men and women become depressed again and about 60 percent, normally within six months of the treatment.
Beyond melancholy, functional MRI of the whole brain could offer insights into other conditions which could be related to changes in brain networks, including autism, schizophrenia and dementia, Schwarzbauer said.