How Electroconvulsive Therapy is Administered Today

How is electroconvulsive therapy (ECT) administered today compared to years ago? Under what conditions is it often used? Is it effective?
Identify and describe the two major brain anomalies in schizophrenia. Discuss how these anomalies were tested, measured, and/or observed.
Describe Alzheimer’s disease in terms of behavioral and cognitive symptoms and underlying neurophysiological characteristics.

Administration of ECT Today:

Modern ECT: Today, ECT is administered under general anesthesia with muscle relaxants to minimize discomfort and prevent injury. Patients are carefully monitored throughout the procedure. The electrical stimulation is delivered through electrodes placed on the scalp, and the patient experiences a controlled seizure that lasts about 30-60 seconds.
Precision and Safety: Advances in technology and technique have improved the precision of ECT, including the use of brief pulse stimulation and right unilateral electrode placement, which can reduce side effects. ECT is also performed in a more controlled environment, with thorough pre-treatment assessments and post-treatment monitoring.

Administration of ECT in the Past:

Older Methods: Historically, ECT was performed without anesthesia or muscle relaxants, which made the procedure quite painful and less safe. The treatment was less controlled, and patients often experienced significant side effects and discomfort.

Conditions for Use:

Indications: ECT is often used for severe psychiatric conditions that have not responded to other treatments, including major depressive disorder, bipolar disorder, and schizophrenia. It is considered when rapid response is needed, or when medications are not effective or contraindicated.
Patient Selection: It’s typically used in cases where the patient has severe symptoms that have not improved with other treatments, or when there are urgent needs such as imminent risk of self-harm.

Effectiveness:

Effectiveness: ECT has been shown to be highly effective, particularly for severe depression and bipolar disorder. It can lead to rapid improvement in symptoms, with many patients experiencing significant relief. However, its efficacy varies, and some patients may experience memory loss as a side effect.

Two Major Brain Anomalies:

Enlarged Ventricles: One of the most consistently observed anomalies in schizophrenia is the enlargement of the lateral and third ventricles in the brain. This is thought to reflect a loss of brain tissue. Techniques like MRI (Magnetic Resonance Imaging) are used to visualize these changes and measure ventricle size.
Reduced Hippocampal Volume: The hippocampus, a critical region for memory and learning, often shows reduced volume in individuals with schizophrenia. This reduction is associated with cognitive deficits and is observed using MRI scans that measure brain structures.

Testing and Measurement:

Imaging Techniques: Both anomalies are commonly tested using neuroimaging techniques such as MRI and CT (Computed Tomography) scans. These technologies allow researchers and clinicians to visualize and quantify structural brain abnormalities.
Autopsy Studies: Post-mortem studies have also been used to confirm these findings by examining brain tissue directly.

Behavioral and Cognitive Symptoms:

Cognitive Decline: Alzheimer’s disease is characterized by progressive cognitive decline, including memory loss, difficulty with language, disorientation, and impaired judgment.
Behavioral Symptoms: Patients may also experience changes in behavior, such as agitation, aggression, and changes in sleep patterns. Personality changes and difficulties with daily activities are common.

Neurophysiological Characteristics:

Neurofibrillary Tangles: One of the hallmark features of Alzheimer’s is the presence of neurofibrillary tangles, which are abnormal aggregates of tau protein inside neurons.
Senile Plaques: The accumulation of amyloid-beta plaques outside neurons is another key feature. These plaques are thought to disrupt cell function and contribute to neurodegeneration.
Neurodegeneration: Alzheimer’s disease is associated with widespread loss of neurons and synapses in the brain, particularly in areas like the hippocampus and cerebral cortex, which are crucial for memory and cognitive functions.