by Researchers from the University of California San Diego have proposed a new hypothesis that could explain the effectiveness of electroconvulsive therapy (ECT) in treating depression. ECT, formerly known as electroshock therapy, involves inducing a brief seizure in the brain using controlled doses of electricity. While ECT has been found to be highly effective for certain mental illnesses, the reasons behind its efficacy have long puzzled the fields of psychiatry and neuroscience.
The researchers conducted two new studies published in Translational Psychiatry, in which they hypothesized that ECT alleviates depression symptoms by increasing aperiodic activity in the brain. Aperiodic activity refers to a type of electrical activity in the brain that does not follow a consistent pattern and is often considered the brain’s background noise.
Sydney Smith, the first author of the studies, stated that they are solving a puzzle that has stumped scientists and doctors since ECT was first developed almost a century ago. In addition, they are helping to demystify one of the most effective, yet stigmatized treatments for severe depression.
Despite its high success rate (up to 80% of patients benefit from ECT), the therapy is often associated with negative images of painful, high voltage shocks. However, Smith emphasized that modern ECT procedures use highly controlled dosages of electricity and are done under anesthesia, unlike what is portrayed in movies or television.
While ECT is generally safe and effective, it does have drawbacks, including temporary confusion and cognitive impairment. The therapy also requires multiple outpatient visits, which can be a barrier for some individuals who could benefit from the treatment.
To study the effects of ECT therapy, the researchers used electroencephalography (EEG) scans to analyze the brain activity of patients with depression who received ECT. They also investigated another similar therapy called magnetic seizure therapy, which induces a seizure using magnets instead of electrodes. Both therapies showed increased levels of aperiodic activity in the patients’ brains after treatment.
Aperiodic activity, which has traditionally been considered the brain’s background noise, is now believed to play an important role in brain function. The researchers suggest that ECT helps restore this function in people with depression. One of the functions of aperiodic activity is to regulate the activation and inhibition of neurons. By boosting inhibitory activity in the brain, aperiodic activity effectively slows down brain activity.
The researchers noted a pattern of slowing brain activity in the EEG scans of individuals who received either ECT or magnetic seizure therapy. While this pattern had previously gone unexplained, accounting for the inhibitory effects of aperiodic activity helps provide an explanation. It also suggests that both forms of therapy have similar effects on the brain.
Although the findings establish a link between aperiodic activity and the benefits of ECT, further investigation is needed to leverage these insights in clinical applications. The researchers are currently exploring the possibility of using aperiodic activity as a metric to gauge the effectiveness of other depression treatments, such as medications.
Ultimately, the most important aspect for patients and doctors is that the treatment works, and ECT has been proven to be effective in treating depression. However, further research into the mechanisms at play during these treatments will help enhance their effectiveness while reducing any negative effects they may have.
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