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Electroconvulsive therapy and lateralized affective systems.

P Flor-Henry

    Annals of the New York Academy of Sciences
    |January 1, 1986
    PubMed
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    This study explores the neurophysiology of generalized and temporal-limbic seizures, linking them to psychosis syndromes. Findings suggest right-hemispheric activity is key in treating depression with electroconvulsive therapy (ECT).

    Area of Science:

    • Neuroscience
    • Psychiatry
    • Epileptology

    Background:

    • Generalized seizures (activated by electroconvulsive therapy - ECT) and temporal-limbic seizures involve distinct neurophysiological systems.
    • Schizophrenia is correlated with the limbic seizure system, while bipolar disorder is linked to the generalized seizure system.
    • These correlations are theoretically related to differing neural substrates underlying these major psychosis syndromes.

    Purpose of the Study:

    • To describe the neurophysiological systems of generalized and temporal-limbic seizures and their interactions.
    • To explore the relationship between these seizure systems and major psychosis syndromes (schizophrenia, bipolar disorder).
    • To review evidence on the role of the right hemisphere in ECT-responsive depression.

    Main Methods:

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    • Review of neurophysiological, neurological, and acoustic threshold evidence.
    • Analysis of studies on electroencephalogram (EEG) changes during psychotropic agent administration.
    • Examination of findings from bilateral and unilateral nondominant ECT in depression treatment.

    Main Results:

    • Evidence suggests ECT-responsive depression involves right-hemispheric neural events.
    • The nondominant hemisphere plays a crucial role in endogenous depressions and their treatment with convulsive therapies.
    • Antidepressant psychotropic agents show asymmetric activation of the right hemisphere (EEG).

    Conclusions:

    • The neurophysiology of generalized and temporal-limbic seizures offers insights into psychosis syndromes.
    • The right hemisphere is critically involved in the pathophysiology and treatment of endogenous depression.
    • Understanding hemispheric lateralization is important for both seizure disorders and affective disorders.