Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_205_библиотеки_им_акад_М_И_Перельмана

hypothalamic-pituitary-adrenal (HPA) axis are also physiological markers of re sponse to ECT (Yao et al. 2019). Most of these findings suffer from problems with specificity and sensitivity that make them difficult to use in prescribing ECT clinically, but they do provide insights into the mechanisms by which ECT exerts its therapeutic effect. The first electroencephalographic findings were from Max Fink (1979), who demonstrated that delta-wave or slow electroencephalographic rhythms during the ECT-induced seizure were necessary for clinical improvement. More recent findings support the use of electroencephalography in predicting response to ECT. Twenty one-channel resting electroencephalography findings showed greater baseline ante­rior delta coherence (hypothesized to show intact neural circuitry, which could allow for better seizure propagation) (Scangos et al. 2019), ictal spectral amplitude and co­herence, shorter latency until slow-wave onset (Krystal et al. 1995), and postictal elec­troencephalographic seizure suppression (Jagadisha et al. 2003; Scangos et al. 2019). However, some studies have found that electroencephalographic seizure expression is not related to ECT response (Nobler et al. 2000). Another line of reasoning is that the postictal response (e.g., reduced blood flow in the frontal regions and increased postictal slow-wave activities) is correlated with clinical response. These researchers hypothesize that the response to ECT is linked to activation of inhibitory GABA mechanisms (Sackeim 1994).