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1 Introduction Electroconvulsive therapy (ECT) is the most effective treatment for severe depressive disorder (Group TUER 2003) but cognitive side effects may deter patients from pursuing it as a treatment option (Koopowitz et al. 2003; Kirov et al. 2016). A major goal is therefore to clarify the neurobiological mechanisms so that procedural refinements can maintain the therapeutic efficacy while minimizing unwanted side effects (Deng et al. 2024).
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