Research on electroconvulsive therapy in India: An overview

The contribution of researchers from India in the field of electroconvulsive therapy (ECT) has been substantial. Over 250 papers have been published by authors from India in the past five decades on this issue; about half of these have appeared in the Indian Journal of Psychiatry. This article summarizes the papers on ECT research that have appeared in the Journal. A bulk of these articles has focused on establishing the efficacy in different disorders. Considerable numbers of papers describe refinement in the ECT procedure, including anesthetic modification, ECT machine and EEG monitoring. Papers on neurobiology of ECT and long-term follow-up of ECT-treated patients form a minority. Despite the decline in the use of ECT across the globe, papers on ECT have only increased in the recent decades in the Journal

Neurohemodynamic correlates of ‘OM’ chanting: A pilot functional magnetic resonance imaging study

Background: A sensation of vibration is experienced during audible ′OM′ chanting. This has the potential for vagus nerve stimulation through its auricular branches and the effects on the brain thereof. The neurohemodynamic correlates of ′OM′ chanting are yet to be explored. Materials and Methods: Using functional Magnetic Resonance Imaging (fMRI), the neurohemodynamic correlates of audible ′OM′ chanting were examined in right-handed healthy volunteers (n=12; nine men). The ′OM′ chanting condition was compared with pronunciation of "ssss" as well as a rest state. fMRI analysis was done using Statistical Parametric Mapping 5 (SPM5). Results: In this study, significant deactivation was observed bilaterally during ′OM′ chanting in comparison to the resting brain state in bilateral orbitofrontal, anterior cingulate, parahippocampal gyri, thalami and hippocampi. The right amygdala too demonstrated significant deactivation. No significant activation was observed during ′OM′ chanting. In contrast, neither activation nor deactivation occurred in these brain regions during the comparative task - namely the ′ssss′ pronunciation condition. Conclusion: The neurohemodynamic correlates of ′OM′ chanting indicate limbic deactivation. As similar observations have been recorded with vagus nerve stimulation treatment used in depression and epilepsy, the study findings argue for a potential role of this ′OM′ chanting in clinical practice

Neurological soft signs in schizophrenia – The past, the present and the future

Clinical neurological abnormalities in patients with schizophrenia have been generally called “Neurological Soft Signs” (NSS). Studies have consistently shown increased NSS in patients with schizophrenia as compared to healthy persons. Early studies were limited by possible confounds of prior neuroleptic medications and illness chronicity. Studies in first episode never treated schizophrenia patients have addressed these confounds. The clinical significance of these findings and the correlation with cognitive dysmetria is the focus of the current review. Relevant literature was obtained using PUBMED and MEDLINE search (1980–2008) and a direct search of reference list of pertinent journal articles. In a 2003 study, neuroleptic-naive schizophrenia patients had significantly more NSS than controls. Patients who were more neurologically impaired had more negative symptoms. Higher NSS scores in treatment-naive schizophrenia patients and the absence of correlation between NSS and illness duration lends support to a neurodevelopmental pathogenesis for schizophrenia. The finding of incoordination and cerebellar signs in most studies also supports the “cognitive dysmetria” explanatory model for schizophrenia. A significant subgroup of patients with schizophrenia may have more neuropathological abnormalities, which predisposes them for a more severe and chronic course of illness. These patients may potentially be identified by clinical neurological examination, which might be very important for prognostication and evolving better methods of treatment for these patients. NSS, by themselves or as a composite index with other neurobiological parameters, hold potential as a candidate endophenotype for schizophrenia