Why Electroconvulsive Therapy is Effective in Treating Depression?

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New Research May Explain Why Electroconvulsive Therapy is Effective in Treating Depression

New Research May Explain Why Electroconvulsive Therapy is Effective in Treating Depression

Two recent studies may have uncovered the mechanisms behind why electroconvulsive therapy (ECT) and its cousin, magnetic seizure therapy (MST), are so effective in alleviating certain mental illnesses, particularly severe depression, a condition that has puzzled psychiatrists and neuroscientists for decades.

Yes, electroconvulsive therapy, also known as “shock therapy,” involves inducing brief seizures of brain symptoms by controlling the dose of electric current and is still in use today.

Although the modern implementation of ECT differs significantly from the scenes portrayed in “One Flew Over the Cuckoo’s Nest,” which may be the most (in)famous depiction of ECT, the therapy still carries a stigma.

New Research May Explain Why Electroconvulsive Therapy is Effective in Treating Depression

Despite its controversial reputation, it cannot be denied that ECT has a significant positive impact on treating certain mental illnesses, especially severe depression, with around 80% of patients experiencing substantial improvement. However, what has puzzled psychiatrists and neuroscientists is how exactly ECT alleviates mental illness. Now, two studies by researchers at the University of California, San Diego, may have provided the answers.

Sydney Smith, the first author and corresponding author of the studies, said, “Many people are surprised to learn that we are still using electroconvulsive therapy, but modern therapy uses highly controlled electrical doses and is conducted under anesthesia. It’s really not like what you see in movies or on television.”

In the first study, researchers used electroencephalograms (EEG) to study the brain activity of patients undergoing ECT for depression. In the second study, they investigated a similar treatment method, magnetic seizure therapy (MST), which induces seizures using magnets instead of electrodes. They found that both therapies increased non-periodic activity in the patients’ brains.

Smith stated, “Non-periodic activity is like background noise in the brain, and scientists have treated it this way for years, not paying much attention to it. However, we now see that this activity actually plays a crucial role in the brain, and we believe that electroconvulsive therapy helps restore this function in patients with depression.”

Neurons continually cycle through periods of excitation and inhibition, corresponding to different mental states. Non-periodic activity helps enhance the brain’s inhibitory activity, effectively slowing down brain activity.

Dr. Bradley Voytek, a professor in the Cognitive Science Department at the University of California, San Diego, and a senior author of the new study, explained how the research contributes to understanding the benefits of electroconvulsive therapy.

Smith said, “We often see a slowing pattern in brain electrical activity scans of people undergoing electroconvulsive or magnetic seizure therapy. This pattern has been unexplained for years, but considering the inhibitory role of non-periodic activity helps explain this pattern. It also suggests that both forms of therapy produce similar effects in the brain.”

The researchers claim that their findings indicate that ECT and MST alleviate depressive symptoms by restoring healthy inhibitory levels in the brain. While these studies establish a connection between non-periodic activity and these therapies, further research is needed to apply these insights to clinical practice.

They are currently investigating the possibility of using non-periodic activity as an efficacy indicator for other depression treatments, including medication.

Dr. Bradley Voytek, a co-author of both studies, stated, “Ultimately, for patients and doctors, the most important thing is that the treatment is effective, and for ECT, it is indeed effective. However, as scientists, our job is to understand what exactly happens in the brain during these treatments, and continuing to answer these questions will help us find ways to make these treatments more effective while minimizing negative impacts.”

Both studies have been published in the journal “Translational Psychiatry.”

The first study, exploring the impact of electroconvulsive therapy on brain activity, can be accessed here.
The second study, investigating the effects of MST, can be accessed here.