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Review
. 2023 Apr 28;13(9):1585.
doi: 10.3390/diagnostics13091585.

Clinical Improvement in Depression and Cognitive Deficit Following Electroconvulsive Therapy

Ahmad Mus'ab Ahmad Hariza  1 , Mohd Heikal Mohd Yunus  1 , Jaya Kumar Murthy  1 , Suzaily Wahab  2
Affiliations
Review

Clinical Improvement in Depression and Cognitive Deficit Following Electroconvulsive Therapy

Ahmad Mus'ab Ahmad Hariza et al. Diagnostics (Basel). .

Abstract

Electroconvulsive therapy (ECT) is a long-standing treatment choice for disorders such as depression when pharmacological treatments have failed. However, a major drawback of ECT is its cognitive side effects. While numerous studies have investigated the therapeutic effects of ECT and its mechanism, much less research has been conducted regarding the mechanism behind the cognitive side effects of ECT. As both clinical remission and cognitive deficits occur after ECT, it is possible that both may share a common mechanism. This review highlights studies related to ECT as well as those investigating the mechanism of its outcomes. The process underlying these effects may lie within BDNF and NMDA signaling. Edema in the astrocytes may also be responsible for the adverse cognitive effects and is mediated by metabotropic glutamate receptor 5 and the protein Homer1a.

Keywords: cognitive deficit; electroconvulsive therapy; hippocampus; neurogenesis; neuronal edema.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The mechanism of ECS, based on preclinical studies. Black arrows indicate pathways leading to neurogenesis. Red arrows indicate pathways leading to cognitive side effects.
Figure 2
Figure 2
The proposed mechanism for how ECT causes transient cytotoxic edema in astrocytes, based on current findings from in vitro and animal studies.
See this image and copyright information in PMC

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