BackgroundAlthough electroconvulsive therapy (ECT) is widely used to treat
psychiatric disorders such as depression, its precise neural mechanisms
remain unknown.AimsTo investigate the time course of changes in cerebral blood flow during
acute ECT.MethodCerebral blood flow was quantified serially prior to, during and after
acute ECT in six patients with depression under anaesthesia using
[15O]H2O positron emission tomography (PET).ResultsCerebral blood flow during ECT increased particularly in the basal
ganglia, brain-stem, diencephalon, amygdala, vermis and the frontal,
temporal and parietal cortices compared with that before ECT. The flow
increased in the thalamus and decreased in the anterior cingulate and
medial frontal cortex soon after ECT compared with that before ECT.ConclusionsThese results suggest a relationship between the centrencephalic system
and seizure generalisation. Further, they suggest that some neural
mechanisms of action of ECT are mediated via brain regions including the
anterior cingulate and medial frontal cortex and thalamus.