A Role for Glia in the Action of Electroconvulsive Therapy : Harvard Review of Psychiatry (original) (raw)
Research Article
1_From Harvard Medical School; Schizophrenia and Bipolar Disorder Unit, McLean Hospital, Belmont, MA._
Original manuscript received 8 March 2004, accepted for publication subject to revision 10 June 2004; revised manuscript received 22 June 2004.
Correspondence: Dost Öngür, AB 347, McLean Hospital, 115 Mill St., Belmont, MA 02478. Email:[email protected]
Abstract
In this article, we consider possible mechanisms of action for electroconvulsive therapy (ECT) based on evidence regarding cellular changes in affective and psychotic illnesses. Postmortem investigations of major depression and schizophrenia have revealed abnormalities in the number of neuronal and glial cells. Such cellular changes could indicate a perturbed balance between neurogenesis and neuronal death in the adult brain. Psychotropic drugs and ECT have been shown to stimulate neurogenesis, giving rise to the hypothesis that this generation of new cells mediates some of their therapeutic effect. A possible trophic effect on glial cells has not been examined. Since glial cells are essential for proper neuronal function, treatments that alter glial function would have significant effects on brain function. We suggest that the effectiveness of ECT is, in part, related to its effect on glial cells. This testable hypothesis may advance our understanding and treatment of psychiatric disorders.(HARV REV PSYCHIATRY 2004;12:253–262.)
© 2004 President and Fellows of Harvard College