ArticleFrontiers in psychiatry2013
Electroconvulsive Treatment: Hypotheses about Mechanisms of Action.
Article in Frontiers in psychiatry, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 87 citations in OpenAlex.
- Neurophysiological biomarkers of treatment response in suicidal ideation: a systematic review.Translational psychiatry · 2025Pooled it
- An international survey of the relatives and friends of electroconvulsive therapy recipients.Psychology and psychotherapy · 2026Article
- History of episodic heavy alcohol use predicts antidepressant effectiveness of ketamine.Psychopharmacology · 2026Article
- Article
- The postictal systems window hypothesis of electroconvulsive therapy in major depression.Frontiers in psychiatry · 2026Article
- New insights into the mechanisms of electroconvulsive therapy in treatment-resistant depression.Frontiers in psychiatry · 2025Review
- Article
- Parsing the Network Mechanisms of Electroconvulsive Therapy.Biological psychiatry · 2022Review
- A response to yet another defence of ECT in the absence of robust efficacy and safety evidence.Epidemiology and psychiatric sciences · 2022Article
- Biomarkers for Deep Brain Stimulation in Animal Models of Depression.Neuromodulation : journal of the International Neuromodulation Society · 2022Review
- Treatment resistance in psychiatry: state of the art and new directions.Molecular psychiatry · 2022Review
- Molecular Biomarkers of Electroconvulsive Therapy Effects and Clinical Response: Understanding the Present to Shape the Future.Brain sciences · 2021Review
- Article
- Dissociative changes in gray matter volume following electroconvulsive therapy in major depressive disorder: a longitudinal structural magnetic resonance imaging study.Neuroradiology · 2019Article
- Indices of Change, Expectations, and Popularity of Biological Treatments for Major Depressive Disorder between 1988 and 2017: A Scientometric Analysis.International journal of environmental research and public health · 2019Article
- Significant Decrease in Hippocampus and Amygdala Mean Diffusivity in Treatment-Resistant Depression Patients Who Respond to Electroconvulsive Therapy.Frontiers in psychiatry · 2019Article
- Factors Affecting Electroconvulsive Therapy Ictal Outcomes: Duration and Postictal Suppression.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2019Article
- A novel Seizure Quality Index based on ictal parameters for optimizing clinical decision making in electroconvulsive therapy. Part 1: development.European archives of psychiatry and clinical neuroscience · 2018Observational
- Antidepressant treatment effects on dopamine transporter availability in patients with major depression: a prospectiveJournal of neural transmission (Vienna, Austria : 1996) · 2018Article
- Electroconvulsive therapy enhances endocannabinoids in the cerebrospinal fluid of patients with major depression: a preliminary prospective study.European archives of psychiatry and clinical neuroscience · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
No consensus has been reached on the mode of action of electroconvulsive treatment (ECT). We suggest that two features may aid in the delineation of the involved mechanisms. First, when effective, ECT would be likely to affect brain functions that are typically altered in its primary recipient group, people with severe depression. Central among these are the frontal and temporal lobes, the hypothalamus-pituitary-adrenal (HPA) stress axis, and the mesocorticolimbic dopamine system. Second, the involved mechanisms should be affected for a time period that matches the average endurance of clinical effects, which is indicated to be several days to a few weeks. To identify effects upon frontal and temporal lobe functioning we reviewed human studies using EEG, PET, SPECT, and fMRI. Effects upon the HPA axis and the dopamine system were assessed by reviewing both human and animal studies. The EEG studies indicate that ECT decelerates neural activity in the frontal and temporal lobes (increased delta and theta wave activity) for weeks to months. Comparable findings are reported from PET and SPECT studies, with reduced cerebral blood flow (functional deactivation) for weeks to months after treatment. The EEG deceleration and functional deactivation following ECT are statistically associated with reduced depression scores. FMRI studies indicate that ECT flattens the pattern of activation and deactivation that is associated with cognitive task performance and alters cortical functional connectivity in the ultra slow frequency range. A common finding from human and animal studies is that ECT acutely activates both the HPA axis and the dopamine system. In considering this evidence, we hypothesize that ECT affects the brain in a similar manner as severe stress or brain trauma which activates the HPA axis and the dopamine system and may compromise frontotemporal functions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.