Electroconvulsive therapy (ECT) deliberately induces generalized seizures to treat severe psychiatric illness, offering a chance to study how consciousness, cognition, and brain activity recover after seizures. Fifteen patients with treatment-resistant major depressive disorder will receive right unilateral ECT under etomidate anesthesia. They will then undergo three treatments in randomized order: etomidate plus ECT, ketamine plus ECT, and ketamine plus sham ECT, repeated for six total sessions. Cognitive tests assess sensorimotor speed, working memory, and executive function before and after each treatment. The study will measure time to return of responsiveness, cognitive recovery trajectories, postictal delirium, and EEG changes. It aims to develop biomarkers for tailoring cognitive and emotional recovery in ECT patients.
Resting-state brain activity may reflect a nonlinear dynamical system with multiple attractors rather than noise-driven fluctuations around a single stable state. Whole-brain dynamical systems models built from individual resting-state fMRI recordings, using the MINDy framework, revealed a diverse taxonomy of attractor landscapes including multiple equilibria and limit cycles. When projected into anatomical space, these attractors mapped onto a limited set of canonical resting-state networks, such as the default mode network and frontoparietal control network, which were reliable at the individual level. Creating convex combinations of models induced bifurcations that recapitulated the full spectrum of found dynamics, suggesting the resting brain traverses diverse dynamics generating distinct but anatomically overlapping attractor landscapes.