The best laid schemes…

“… one participant (ECT) fell asleep during the fMRI scan”

The scans were being conducted by Kamilla Miskowiak and colleagues in Copenhagen, Denmark (Neural response after a single ECT session during retrieval of emotional self-referent words in depression: a randomized, sham-controlled fMRI study, International Journal of Neuropsychopharmacology).

People who had been prescribed electroconvulsive therapy (ECT) were randomised, for their first treatment only, to either ECT or sham ECT (the anaesthetic, etc., without the actual electric shock). The next day the researchers carried out fMRI scans on them. The researchers found that:

“A single ECT session had no effect on hippocampal activity during retrieval of emotional words. However, ECT reduced the retrieval-specific neural response for positive words in the left frontopolar cortex. This effect occurred in the absence of differences between groups in behavioral performance or mood symptoms.”

They concluded that ECT may facilitate memory for positive self-referent information and thus increase feelings of self-worth.

The researchers also got another article out of the same experiment, this time in the Journal of Psychopharmacology, September 2017 (Does a single session of electroconvulsive therapy alter the neural response to emotional faces in depression? A randomised sham-controlled functional magnetic resonance imaging study.) They concluded:

“Despite no statistically significant shift in neural response to faces after a single electroconvulsive therapy session, the observed trend changes after a single electroconvulsive therapy session point to an early shift in emotional processing that may contribute to antidepressant effects of electroconvulsive therapy.”

This time the researchers suggested the antidepressant effect was mediated by a “lower fear vigilance”. All the ECT group managed to stay awake for this part of the experiment.

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3 Responses to The best laid schemes…

  1. Welton says:

    How soon after the single ECT? If it was the next day or two, the participants in the study might have still been under the influence of the anesthetic used during ECT. Also, were the participants in the study taking antidepressents? Phenothiazines? Other drugs that might have affected their “emotional processing?” This is a horrible experiment, written up in obscure rhetoric with a subjective, theory written as a conclusion. Maybe the “lower fear vigilance” was a result of having recently had an ECT and knowing they would not be getting another one soon. I experienced this many times during the almost 4 years I was shocked. As soon as one was over I was relieved because I knew I would not be subjected to another one in the next few days (later during maintenance treatment, the treatments were further apart.) But as the next one drew closer, the fear came on stronger each time. Each treatment was horrific. I feared them more and more, the more of them I received.

  2. Welton says:

    PS: It is fairly common that people subjected to ECT more than once (presumably the people in this experiment had only received one ECT) develop a fear that increases with each treatment. If they don’t experience fear with the first few treatments, they go on to develop fear as the treatments continue. I remember that the “inventor” of ECT comments on this in some of his original notes. I believe that the increasing fear indicates some kind of physical reaction to physical damage — damage to the brain and memories.

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