Effect of electroconvulsive therapy on neural oscillations in schizophrenia: A magnetoencephalography resting-state...

Schizophrenia is a complex, chronic mental disorder, and pharmacologic treatment alone is often insufficient. Electroconvulsive therapy (ECT) is a rapid-acting and widely employed physical intervention for schizophrenia, yet its underlying mechanisms remain elusive. The present study aims to elucidate how ECT modulates brain activity in patients with this disorder.

A total of 26 patients with schizophrenia scheduled for ECT and 24 age- and sex-matched healthy controls were recruited. Resting-state magnetoencephalography (MEG) data and clinical assessments, including the Positive and Negative Syndrome Scale (PANSS) and Montreal Cognitive Assessment (MoCA), were acquired at baseline for patients with schizophrenia, and were repeated after the 3rd and 6th sessions of ECT.

We found that, at baseline, patients exhibited characteristic abnormalities: elevated delta power, reduced alpha power, and a slower individual alpha peak frequency (IAPF) compared to the healthy controls. Following ECT, brain activity evolved in a gradual but consistent manner-slow-wave (delta and theta) power increased, whereas fast-wave (alpha, beta, and gamma) power declined. Importantly, the reduction in beta power over the bilateral prefrontal and right central cortices was significantly associated with the amelioration of positive symptoms in patients with schizophrenia.

Our findings suggest that ECT may induce a profound, progressive therapeutic shift in the brain's electrophysiological state, characterized by a spectral rebalancing toward slow-wave dominance. The selective suppression of prefrontal/central beta power appears to be a key neurophysiological correlate of clinical improvement, providing a putative mechanistic target for optimizing ECT protocols.