Psychiatric, Motor, and Autonomic Effects of Bifrontal ECT in Depressed Parkinson's Disease Patients

Electroconvulsive shock and transcranial magnetic stimulation do not alter the survival or spine density of adult-born striatal neurons

Adult neurogenesis has most often been studied in the hippocampus and subventricular zone-olfactory bulb, where newborn neurons contribute to a variety of behaviors. A handful of studies have also investigated adult neurogenesis in other brain regions, but relatively little is known about the properties of neurons added to non-canonical areas. One such region is the striatum. Adult-born striatal neurons have been described in both rodents and humans, but the regulation of these neurons is poorly understood. Since striatal dysfunction occurs in Parkinson's disease, which is amenable to neurostimulation therapies, we investigated whether electroconvulsive shock (ECS) or transcranial magnetic stimulation (rTMS) modulate neuroplasticity of adult-born striatal neurons. Adult-born cells were labelled in transgenic mice and 8 days later mice were given 10 stimulations over the course of 3 weeks. Adult-born striatal neurons were consistently observed in all groups. Their dendritic morphology and expression of DARPP32 and NeuN indicated a medium spiny neuron phenotype. However, neither ECS nor rTMS altered the number of new neurons, and both treatments also had no effect on the density of dendritic spines compared to unstimulated controls. These results suggest that neither ECS nor rTMS alter early neuronal survival or morphological plasticity at postsynaptic sites in the striatum.

Efficacy of Electroconvulsive Therapy for the Treatment of Movement Disorders: A Literature Review

Electroconvulsive therapy (ECT) is a safe and effective treatment modality for various psychiatric disorders. However, evidence suggests a putative role of ECT in treating movement disorders that are refractory to less invasive modalities. ECT is primarily used in treatment-resistant psychiatric disorders. However, growing evidence exists for its use in movement disorders with and without psychiatric comorbidity.

The primary objective of this systematic review was to examine the efficacy of ECT as a primary treatment modality for movement disorders. Relevant, peer-reviewed publications were retrieved from PubMed, SCOPUS, CINAHL, and PsycINFO. Keywords related to ECT and movement disorders were used as search phrases to identify relevant articles. A total of 90 articles that met the inclusion criteria were included in this review. Core findings were subsequently appraised on the role of ECT in treating movement disorders.

Inclusion and exclusion criteria were developed to guide the search and selection process. Sources that met the inclusion criteria were those published between 2001 and January 2023. Additionally, peer-reviewed journals published in the English language covering the role of ECT in movement disorders were deemed appropriate for inclusion. Sources published before 2001, written in a non-English language, and not from peer-reviewed journals were excluded from this systematic review. The exclusion criteria also entailed eliminating duplicates from the review list.

Most reviewed sources revealed that ECT improved outcomes in symptoms associated with various movement symptoms. However, ECT does not have a long-lasting impact on neuroacanthocytosis symptoms. Additionally, ECT is negatively associated with aggression and agitation, two of the most critical movement symptoms of Alzheimer’s disease.

Evidence affirms the efficacy of ECT in providing symptomatic relief for movement disorders aside from psychiatric comorbidities. This positive association highlights the need for randomized controlled studies to identify movement disorder sub-populations that may respond to ECT.