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Neurophysiological Variability in the Effects of the ECT Stimulus
Harold A. Sackeim1, Sukdeb Mukherjee
1Department of Biological Psychiatry, New York State Psychiatric Institute; Department of Psychiatry, College of Physicians and Surgeons, Columbia University; N.Y.S.P.I. Division at Creedmoor Psychiatric Center; and Department of Psychology, New York University, New York, New York, USA.
Abstract:
There is evidence that, in addition to seizure elicitation, critical factors in therapeutic response to ECT may include aspects of stimulus parameters and electrode placement. Dr. Abrams suggests that these factors contribute to efficacy by influencing the degree of seizure generalization, diencephalic stimulation, and relative asymmetry in the slowing of EEG frequencies. An alternative view is presented here, which hypothesizes that these factors converge in influencing the regional distribution and strength of the endogenous inhibitory process that terminates the seizure.