Neurophysiological Variability in the Effects of the ECT Stimulus.

There is evidence that, in addition to seizure elicitation, critical factors in therapeutic response to ECT may include aspects of stimulus parameters and electrode placement. Dr. Abrams suggests that these factors contribute to efficacy by influencing the degree of seizure generalization, diencephalic stimulation, and relative asymmetry in the slowing of EEG frequencies. An alternative view is presented here, which hypothesizes that these factors converge in influencing the regional distribution and strength of the endogenous inhibitory process that terminates the seizure.