request good review article (ECT)

F. Frank LeFever flefever at ix.netcom.com
Sun Nov 22 23:08:22 EST 1998


Deep in the following exchange, John inserted two requests for further
info; one re the corpus callosum and neurochemical interhemispheric
balance, and another about cc function more broadly.

re cc and neurochem balance:

Glick, S.D. et al. (1975) Nature, 254, 616-617.

This was in the context of a long series of papers on various aspects
of hemispheric asymmetries (usually focused on caudate differences),
for which do a Medline search for years c. 1974-84?  I had forgotten,
until I pulled his file to answer John's request, that I had invited
Stanley to speak to a meeting of the New York Neuropsychology Group, c.
1983!  He sooon relocated to Albany, and much of his recent work has
been on aspects of the neurochemistry of drug addiction, which I
personally do not find so intteresting as the interhemispheric
relations work; but he is still doing some of that--viz., 

Carlson, J.N. et al. (incl. Glick)(1996) Brain Research, 711, 1-9.

Carlson, J.N. et al. (ditto) (1996) Brain Research, 707, 122-126.

For other approaches to interhemispheric relations (mainly via cc),
here are a few oldies from my files:

Williamson, P.D. et al. (1985) Neurology, 35, 1069-1071.
(relevant to the idea that a malfunctioning hemisphere can interfere
with an intact hemisphere's performance of a task)

Liederman, J. et al. (1985) Neuropsychologia, 23, 673-683.
(relevant to interhemispheric collaboration)

Dennis, M. (1976) Neuropsychologia, 14, 455-469.
(suggests role for callosal inhibition in development)

Banquet, J.P. (1983) Electroencephalography and Clinical
Neurophysiology, 55, 51-59.
(provocative suggestion of role for cc in phase synchronization, in
contrast to frequency synchronization via thalamo-cortical circuits)

More recent work?  Liederman still in busines (q.v.)
Using Ovid disk for last 4 yrs of Medline, search strategy using
"interhemispheric AND cognition" yielded 13 articles; "interhemispheric
AND inhibition" yielded 16 more.

for ex:

Baynes, K. et al. (1998) Science, 280, 902-905

F. Frank LeFever, Ph.D.
New York Neuropsychology Group







In <7319r3$mbv$1 at news.bix.asn.au> "John" <go at away.com> writes: 
>
>
>
>>In article <7304ug$h5d at sjx-ixn3.ix.netcom.com>,
flefever at ix.netcom.com(F.
>>Frank LeFever) wrote:
>>
>>> It is obvious that this fellow is off on a trip of his own, so
there
>>> would be little point in replying to him; however, there is the
danger
>>> that someone not sophisticated enough to discount his comments
might be
>>> led to reject a treatment that could be life-saving.
>>>
>>> See comments below:
>>>
>>>
>>> In <3650E7E9.57FC5323 at pop3.concentric.net>
kkollins at pop3.concentric.net
>>> writes:
>>> >
>>> >"Good"-Grief, Frank, you "embarrass" me :-)
>>> >
>>> >F. Frank LeFever wrote:
>>> >
>>> >> Again, kkollins pontificates from his position of authority
based on
>>> no
>>> >> more than popular fiction (e.g. One Flew Over the Cuckoo's
Nest).
>>> Is
>>> >> your response a joke or are you really ignorant of the practice
of
>>> >> unilateral ECT?
>>> >
>>> >Without Physically-separating the hemispheres, there's nothing
>>> "unilateral"
>>> >that occurs in the nervous system... yes, one can try to "steer"
such,
>>> but
>>> >what do you think the cortical targets of the commisural fibers
do?
>>> >..."opt-out?
>>>
>>> First, a general observation: we have often seen (in this
newsgroup)
>>> people who know a little bit about something (often scattered and
>>> poorly-undertood terms and facts) assume that others know even
less,
>>> adolescent "big insights" proclaimed naively (to others who had and
>>> worked through such "insights" long ago) as if it were a private
>>> revelation, etc., etc.
>
>
>A good observation. As an individual with rather eclectic interests I
have
>frequently noticed that when I first look into an area of interest I
start
>seeing things here and there. I take down a few notes, draw some
hopefully
>promises speculations therefrom, test and find them good and so feel
quite
>good about myself until one day (usually months later) I read where
someone
>has considered the idea and have thoroughly thrashed it out (sometimes
>right, sometimes wrong). It takes a while but eventually you realise:
>
>If something makes so much sense to you that you cannot understand why
>others have not thought of it before one of three possiblities exist:
>
> someone has, you just haven't read enough.
> someone has, and they know why its a stupid idea.
> no-one has, see a psychiatrist.
>
>I use this formula as a standard epistemological heuristic, I only
wish more
>would adopt it.
>
>>> In this particular case, kkollins assumes that someone who has been
>>> studying brain function for several decades, has done research at
the
>>> physiological/anatomical level as well as at the
cognitive/behavioral
>>> level as a (doctoral level) clinical and experimental
neuropsychologist
>>> has not done even as much reading as he has about interhemispheric
>>> relations.  Naive, arrogant, presumptious!
>
>
>Consider the number of self help books kicking around relying on
popular
>neuroscience. I think its part of being human, most people are
fascinated by
>the grey stuff upstairs and many, myself included, wish to sound
>knowledgeable about such stuff. Unfortunately I am just confused about
it
>all these days, but of course when speaking to others I throw out airs
of
>authority ... .
>
>>> Besides a pretty good general professional knowledge of not oonly
the
>>> corpus callosum but also the anterior commissure, posterior
commissure,
>>> and hippocampal commissure (to say nothing of indirect influences
via
>>> the diencephalon), there are several more "personal" experiences to
>>> keep me alert to interhemispheric relationships.
>>>
>>> For ex., about 35 years ago, in preparation for research with a
recent
>>> post-doc from Sperry's lab (a "classmate" of Gazzaniga's), I was
>>> practicing corpus callosum section and unilateral hippocampal
excisions
>>>  in (dead) cat heads--project fell through when NYU delayed too
long in
>>> buying cages for LIVE cats.
>>>
>>> For ex., about 18-20 years ago, one of my patients with MS, a
>>> right-hander, switched to the left hand to do the Block Design
(WAIS).
>>> Having seen demonstrations of the superiority of left-hand Block
Design
>>> performances  by split-brain patients (compared to right-hand), I
had
>>> the sudden insight that inasmuch as the corpus callosum is the
largest
>>> myelinated stucture in the brain, MS patients may have a partial
>>> disconnection syndrome--unfortunately, did not write this up, but
>>> others have indeed demontrated that this is true.
>>>
>>> For ex., sometime in the past 20-30 years, a former student of mine
>>> (Stanley Glick) found that the CC was impoortant in
neurotransmitter
>>> balance across the hemispheres--after it was cut, prior DA
asymmetries
>>> increased and ACh asymmetries developed.
>
>
>This sounds interesting, where can I read about it?
>
>>> About 15 years ago, using a computer-driven visual display I built
>>> (LEDs in a plexiglass dome) I was able to replicate Brend Milner's
>>> finding of a slight latency difference between ipsilateral and
>>> contralateral reaction times in a patient with callosal agenesis
(about
>>> the same order of magnitude as she found, if I recall correctly).
>>>
>>> More recently (5-6 yrs?), a former colleague, Robert Sloviter,
>>> described long inhibitory fibers from each hippocampus to the other
(I
>>> heard it from the horse's mouth).
>>>
>>> ACCOORDINGLY, you may be sure I did not forget callosal
transmission
>>> when I wrote about unilateral vs. bilateral ECT.  The difference
>>> between kkollins inferences and mine lies in the fact that I know
>>> something about ECT and he apparently does not.
>>>
>>> There have been and coontinue to be many studies comparing
unilateral
>>> and bilateral ECT.  Hormonal responses, clinical outcomes,
cognitive
>>> effects have been compared (unilateral vs. bilateral).
>>>
>>> Yes, of course seizure propagation from right to left cortex is to
be
>>> expected, but the latest EEG evidence I know of shows concordance
>>> mainly in the froontal lobes (which is the preferred target for
>>> neurophysiological changes, inasmuch as functional imaging studies
show
>>> them to be most important), but much less between posterior areas.
>>> Indeed, it has been suggested that the decreased cognitive
side-effects
>>> (transient and mild, n.b.) with unilateral ECT is due to the
>>> procedure's eliciting less seizure activity in left temporal (and
>>> occipital) areas.
>
>
>Talking of the cc, can you direct me to a good text dealing with
theories
>regarding just what is happening here? I sometimes wonder if the cc is
>overlooked to some extent yet this massive bundle must provide
important
>clues. Is it true that across the visual cortex the numbe of cc
connections
>increases from primary to tertiary visual structures? If so, can you
>speculate on what this may indicate?
>
>Kkollins complaint about ECT may have some historical validity but I
>understand the procedure has been refined over the years and proving
to be
>much more effective. The situation reminds me of the lobotomy hassles
>decades ago. While there were some grievances to be addressed here,
from
>what I can gather the whole ruckus grew more out bad public reporting
than
>the predominant medical practice at the time.
>
>>> >"Depression" is an engineered-in, fully-functional mechanism upon
>>> which
>>> >Survival depends.
>>> >
>>>
>>> So is activation of the HPA axis by various stressors; but
unregulated
>>> activation can be harmful to the individual.  Perhaps kkollins has
in
>>> mind "Survival of the Fittest" (as crudely construed by those who
don't
>>> really understand Darwin)? Racial improvement via individual
suicide?
>
>
>Oh go read Dawkins, the trouble people go to in trying explain suicide
in an
>evolutionary perspective.
> >> I can only hope that his unfounded
>>> >> but confident assertions do not
>>> >> discourage someone from taking advantage of a therapy which DOES
>>> work
>>> >> for many depressives who still suffer and do not respond well to
any
>>> >> medication.
>
>That's what we amateurs hate about you experts. How can we sound
clever with
>people like you around Frank? Your comments re the use of this
treatment is
>exact, the ECT therapy is utilised when other measures have failed,
and as
>someone who suffers occasionally from severe depression I can assure
you
>evolution has nothing to do with it. My bet is that the frontal lobes,
one
>if not the last areas to undergo expansion during our evolution, have
not
>been sufficiently fine tuned by the evolutionary process and so things
will
>tend to go awry on occasions. Many psychiatric conditions seem to
relate to
>frontal lobe dysfunction.
>
>
>kkollins should take a leaf out of my book. If he wants to run wild
>speculations around he should become a Rugrat, as I was not so long
ago. It
>can be a useful game, but only if you remember it is a game.
>
>Finally, many people on ngs like myself learn a good deal through well
>informed ng posters. This is the only place I can discuss these things
as
>none of my friends or associates are interested in this stuff.
>
>The Astonishing Hypothesis: The Scientific Search for the Soul, Crick,
>Francis
>
>251
>"At times I even persuade myself that I can glimpse some of the
answers, but
>this is a common delusion experienced by anyone who dwells too long on
a
>single problem."
>
>
>Too curious for my own good,
>
>
>John
>johnhkm at logicworld.com.au
>
>




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