Cerebral blood flow in schizophrenia.
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Biomedical subjects
Publications and source records attributed to S Malitz.
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Postictal excitement was observed in two patients following bilateral and/or right-unilateral ECT but not following left-unilateral ECT. The findings agree with reports associating a similar syndrome with right-side brain insult.
A right-handed 42-year-old man with bipolar II disorder according to the Research Diagnostic Criteria was tested during two depressive phases, a hypomanic phase, and after a series of left ECT treatments. While drug free he was given a set of tasks sensitive to asymmetry in hemispheric activation. The results indicated hyperactivation of the right hemisphere during the hypomanic episode and of the left hemisphere during the depressive episodes. After left ECT, the patient evidenced greater symmetry. The authors suggest that this case is an instance of reversed lateralization in the regulation of positive and negative mood states.
The efficacy of electroconvulsive therapy (ECT) in the treatment of affective disorders is well established. Despite its clinical utility, there is no generally accepted theory regarding its mode of action. Several lines of evidence indicate that ECT has significant anticonvulsant properties and results in decreased neural metabolic activity. We suggest that these effects are due to enhanced gamma-aminobutyric acid (GABA) transmission and that localized suppression of neural metabolic activity is associated with therapeutic response to ECT. An implication of this view is that ECT may be a useful adjunctive treatment in intractable epilepsy.
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