Changes in psychiatric symptoms related to EEG and cerebral blood flow following electroconvulsive therapy in depression

Abstract

Changes in psychiatric symptoms following electroconvulsive therapy (ECT) were related to alterations in global EEG and cerebral blood flow (CBF) in 21 in-patients suffering from depression. They were examined by clinical ratings, EEG, and CBF immediately before and 1 to 3 h after treatments during an ECT series and at follow-up. Four symptom clusters from a factor analysis of symptoms in depression, representing different dimensions of emotion, cognition, and psychomotor retardation, were used for clinical description. The changes in the separate symptom clusters showed different patterns and also different correlations with neurophysiological (EEG and CBF) changes during the course of serial ECT. Furthermore, acute clinical and neurophysiological effects following single ECT's were found to be different from non-acute changes, building up during the treatment course. Acute relief in symptoms of anxiety, depressed mood, and psychomotor retardation correlated with an acute slowing of the EEG. Regarding non-acute effects a reversed relationship was found, i.e. improvement in symptoms of depressed mood and psychomotor retardation was related to less EEG slowing. As opposed to the acute clinical changes, the non-acute changes, found following the first two or three treatments of a series, contained predictive information about the individual clinical outcome of the patients.

Seizure (Ictal)—EEG Characteristics in Subgroups of Depressive Disorder in Patients Receiving Electroconvulsive Therapy (ECT)—A Preliminary Study and Multivariate Approach

“…The high remission rate (95%) after ECT in psychotic depressed patients as compared with depressed patients without psychotic features (83%) supports the argument that psychotic depression is a distinguishable nosological entity [ 24 ]. The EEG characteristics reported in our study agree in general with earlier reports [ 25 – 27 ].…”

The Functional Anatomy of Psychomotor Disturbances in Major Depressive Disorder

“…Interestingly, this study also showed that only clinical ratings more focused on PMD than the Hamilton depression ratings scale (HDRS) predicted P300 latency. In a group of patients receiving electroconvulsive treatment, clinical ratings of PMD were positively correlated with frequency decreases during initial improvement, whereas the reverse relationship was found during the later partial remission phase ( 32 ). One study by Nieber et al ( 33 ) showed a positive correlation between decreased frequencies in particular regions of the theta and alpha (7–13 Hz) spectrum and overall retardation, with motor retardation, in particular.…”

Encoding, Consolidation, and Renormalization in Depression: Synaptic Homeostasis, Plasticity, and Sleep Integrate Rapid Antidepressant Effects

“…The emergence of rebound SWA is not limited to pharmacological agents that possess antidepressant properties. Postictal increases in SWA after ECT are widely documented, and other convulsive therapies, such as flurothyl, share similar features (Chusid and Pacella, 1952;Fink and Kahn, 1957;Chatrian and Petersen, 1960;Kriss et al, 1978;Silfverskiöld et al, 1987;Sackeim et al, 1996;Perera et al, 2004). Notably, pronounced postictal EEG slowing has been associated with rapid antidepressant responses (Folkerts, 1996) and clinical improvement after ECT (Nobler et al, 1993;Suppes et al, 1996).…”