Paradoxical metabolic response of the human brain to a single electroconvulsive shock

Sermet, Eric; Grégoire, Marie‐Claude; Galy, G.; Lavenne, F.; Pierre, Christian; Veyre, Laurent; Lebars, D; Cinotti, L.; Comar, D.; Daléry, J; Bobillier, Pierre

doi:10.1016/s0304-3940(98)00650-8

Cited by 19 publications

(5 citation statements)

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“…17 Hippocampal neurogenesis, recently postulated to be related to the therapeutic effect of ECT, may also occur. 20 The advantages of offering the minimum number of treatments are clear in cost and cumulative risk of adverse effects. 18 Changes in neurotransmitter levels in the frontal cortex after a single ECT in the rat model include increases in extracellular concentrations of dihydroxyphenylacetic acid, homovanillic acid, and 5-hydroxyindoleacetic acid.…”

Section: Discussionmentioning

confidence: 99%

Resolution of Severe Suicidality With a Single Electroconvulsive Therapy

Kobeissi

Aloysi²,

Tobias³

et al. 2011

The Journal of ECT

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Electroconvulsive therapy is a rapid and effective treatment of severe depression that has been shown to quickly decrease or eliminate suicidal thoughts and behaviors. We describe the case of an 88-year-old man hospitalized for a carefully premeditated suicide attempt with highly lethal means. He was treated with a single electroconvulsive therapy (ECT) and improved markedly. His suicidal ideation remitted, and the patient was still free of suicidal ideation at 5 months of follow-up. We discuss the effect of ECT on suicidal ideation, the benefit of minimizing the number of total ECT treatments, and the possible biological markers of change after a single treatment in an ECT-naive patient.

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Section: Discussionmentioning

confidence: 99%

Resolution of Severe Suicidality With a Single Electroconvulsive Therapy

Kobeissi

Aloysi²,

Tobias³

et al. 2011

The Journal of ECT

View full text Add to dashboard Cite

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“…Electroconvulsive therapy is used in humans with severe depressive disorders and has been shown to be effective in 85–90% of cases with mood and memory improvement (42). Interestingly, a single ECS has been shown to lead to a quite large activation in protein synthesis in both humans (43) and rats (44). The activation of this metabolic pathway may be linked to the positive effects of this type of seizure on mood and memory, possibly mediated by the consequences of the electroconvulsive treatment on neurotransmitters, neurotrophic factors, and gene expression (45,46).…”

Section: Discussionmentioning

confidence: 99%

Dynamic Variations of Local Cerebral Blood Flow in Maximal Electroshock Seizures in the Rat

2002

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Summary:Purpose: Measurement of cerebral blood flow is routinely used to locate the areas involved in generation and spread of seizures in epilepsy patients. Because the nature of the hyperperfused regions varies with the timing of injection of tracer, in this study, we used a rat model of maximal electroshock seizures to follow up the time-dependent changes in the distribution of seizure-induced cerebral blood flow (CBF) changes.Methods: CBF was measured by the quantitative autoradiographic [ 14 C]iodoantipyrine technique over a 30-s duration. The tracer was injected either at 15 s before seizure induction, simultaneous with the application of the electroshock (tonic phase), at the onset of the clonic phase, or at 3 and 6 min after the seizure (postictal phase).Results: Rates of CBF underwent dynamic changes during the different phases of seizure activity and largely increased over control levels (Յ400%) in the 45 regions studied during all phases of the seizure (first 3 times). CBF remained higher than control levels in 35 and 15 areas at 3 and 6 min after the seizure, respectively.Conclusions: The distribution of maximal CBF increases showed a good correlation with their known involvement in the circuits underlying the clinical expression of the different types of seizure activity, tonic versus clonic. Key Words: Cerebral blood flow-[ 14 C]iodoantipyrine-Seizures-Electroshock.A number of patients with symptomatic or cryptogenic epilepsies are medically intractable and need the surgical resection of the epileptic focus (1-3). The success of surgery depends substantially on the validity of the data used for the location of the seizure focus (4,5). The methods available to localize the epileptic focus include seizure characterization; neurologic examination; neuropsychological testing; magnetic resonance imaging; functional brain imaging of blood flow with singlephoton emission computed tomography (SPECT) and of glucose utilization with positron emission tomography (PET); video/scalp electroencephalographic (EEG) recording; and video electrocorticography (ECoG) with depth, subdural, or epidural electrodes (6,7).Most epilepsy centers tend to perform less-invasive monitoring (8) and use quite routinely local cerebral blood flow (LCBF) measurement by SPECT with hexamethylpropylene amine oxime (HMPAO) or ethyl cysteinate dimer (ECD) labeled with 99m-technetium. Ictal SPECT shows increased LCBF in the epileptic focus in ∼95% of patients with temporal lobe epilepsy (4,5,9,10).However, there has been considerable discussion regarding the optimal timing of early postictal LCBF analysis (5,11,12) since the nature of the territories hyperperfused during the seizure varies with the timing of injection of the tracer. Thus the recognition of the dynamic process of ictal brain perfusion alteration is essential for the application of ictal/postictal SPECT LCBF measurement to localize the epileptic focus and the secondary spread of seizures.Therefore we used an animal model of seizures induced by maximal electroshock to observe...

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“…Because the available data support this, there may be a possibility of activation of COX an increase in free radical production leading to oxidative stress and apoptosis of GABAergic neurons, thus increasing the glutamate and causing epileptic discharges [3] . So COX‐2 inhibitors might be acting through GABAergic neurons thus increasing the inhibitory neurotransmitter and the expression of GABA receptor protein [3,27–29] …”

Section: Discussionmentioning

confidence: 98%