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Electroconvulsive Therapy (ECT) in Parkinsons Disease: ECS and Dopamine Enhancement

Cumper, Samantha K. BS; Ahle, Gabriella M. BA; Liebman, Lauren S. BA; Kellner, Charles H. MD

doi: 10.1097/YCT.0000000000000142
Invited Reviews

Introduction: In addition to its effects in major psychiatric illness, electroconvulsive therapy (ECT) is known to have a beneficial effect on the core motor symptoms of Parkinson’s disease (PD). This effect is believed to be mediated via dopamine in the striatum. Electroconvulsive shock (ECS), the animal analogue of ECT, is the model in which investigators have sought to elucidate the specific dopaminergic mechanisms by which ECT exerts its therapeutic effect in PD. Electroconvulsive shock has been given to intact animals as well as to animals with neurotoxic lesions that create parkinsonism.

Methods: In this paper, we selectively review the electroconvulsive shock literature on dopamine in the striatum.

Results: Electroconvulsive shock, and by extension, ECT, is associated with increased dopamine release and modulation of dopamine receptors.

Conclusion: Better understanding of how ECT works to enhance dopaminergic systems in the brain could help to make it a more accepted treatment for PD.

From the Icahn School of Medicine at Mount Sinai, New York, NY.

Received for publication February 18, 2014; accepted March 20, 2014.

Reprints: Charles H. Kellner, MD, Icahn School of Medicine at Mount Sinai, New York, NY (e-mail: charles.kellner@mssm.edu; jaclyn.bencivenga@mssm.edu).

Dr Kellner receives grant support from the NIMH, honoraria from the North Shore-LIJ Health System, UpToDate, and Psychiatric Times, and royalties from Cambridge University Press.

The authors have no conflicts of interest or financial disclosures to report.

© 2014 by Lippincott Williams & Wilkins