Electroconvulsive therapy used to be called electroshock therapy and it was developed in 1938 to treat certain mental disorders. Its history is not a rosy one.
“It’s earned itself a bit of a gnarly reputation because it has been used often without consent and without consideration for the comfort of the patient,” said Sydney Smith, a doctoral candidate in neurosciences at UC San Diego.
Mention “shock therapy” and many people remember actor Jack Nicholson’s frightening convulsions in the movie “One Flew Over the Cuckoo’s Nest” after electrical charges were applied to his head.
But electroconvulsive therapy (ECT) works. And UC San Diego researchers say it’s thanks to a mysterious brain activity that shuts down brain cells that cause serious depression and other mental diseases.
It’s called aperiodic activity.
“We found that ECT massively increases the amount of aperiodic activity in the brain — that background noise that nobody had been really paying attention to,” Smith said. “By increasing aperiodic activity, it’s increasing the brain’s ability to kind of shut itself off a little bit, which is really necessary for patients with depression.”
To neurologists aperiodic activity refers to electrical currents in the brain that are not brain waves. Called background noise by some, Smith compares it to something you hear at a symphony performance.
If brain waves are the music, aperiodic activity is like the cacophonous sound you hear before the performance when musicians are tuning their instruments.
Based on the UCSD research, aperiodic activity stops the firing of neurons that lead to depression.
“There are some classes of neurons called inhibitory neurons that suppress the firing of neurons. And it looks like, in certain parts of the brain, that suppression mechanism is maybe disrupted in depression,” said UCSD professor Bradley Voytek, a neuroscientist who worked with Smith on the research.
He adds that electroconvulsive therapy seems to restore the brain’s ability to inhibit neurons that cause some mental illnesses.
Researchers say we have a ways to go in understanding the workings of aperiodic activity. But doctors have seen the curative effects of ECT and it remains a common practice. Voytek estimates that in one UCSD clinic about a couple dozen patients a year take advantage of ECT.
“In medicine if something works, and it shows to have very low side effects, then keep doing it. Right?” he said. “But scientifically we really want to find out the essence of why and how it’s working so we can minimize the side effects.”
Today, people who receive electroconvulsive therapy are given a general anesthetic. Further research could lead to a process that is more comfortable for the patient and maybe more effective.
