Towards solving enigmas in electrical injury.

The paper by Park and colleagues in the previous issue of Critical Care highlights vascular changes in electrical injury and finds them to be relatively long-lasting and significant. This finding is consistent with long-lasting disability seen clinically in electrically injured patients. Furthermore, the authors report that the changes seen in the shocked part of the body are accompanied by similar changes that are measurable in other parts of the body but that are not involved with electric current. This latter finding is of significant importance. A psychological syndrome - consistent and predictable - exists following an electrical injury. The causation is enigmatic. Recent psychiatric research indicates the importance of circulating cortisol and brain-derived neurotrophic factor (BDNF), which causes loss of hippocampal volume, in the genesis of depression. This psychiatric research has stimulated a speculative theory of the genesis of the psychological effects of electric shock. The paper by Park and colleagues is circumstantial support for the possibility that such a process is real and available.