… and there's no proof of lasting brain damage

Sir

Peter Sterling¹ asserts that electroconvulsive therapy (ECT) damages the cerebral hemispheres. A comprehensive review of the relevant literature provides no objective evidence that ECT is capable of causing brain damage in human beings^2,3.

In support of his belief that psychiatrists would find evidence for ECT-induced brain damage if only they would test for it, Sterling cites a single study, conducted more than 50 years ago. In sharp contrast are the many studies in the modern era examining short- and long-term memory before and after bilateral or unilateral ECT, examining both left- and right-hemisphere functions and including non-ECT control groups for comparison. All but one of these studies reveals no evidence for persistent or long-term deficits².

The single positive study⁴ found detectable deficits in autobiographical memory six months after bilateral (but not unilateral) ECT. Unfortunately, this was published only in academy proceedings, which are not subjected to peer review.

Sterling's claim that ECT “releases massive quantities of glutamate”, thus causing neuronal death, is not supported by any citation. However, myelin basic protein, which is found in the cerebrospinal fluid following stroke, does not appear there following ECT⁵, nor does the CPK brain isoenzyme⁶.