How does the measurement of anesthetic depth using the patient state index influence the course of electroconvulsive therapy in patients with major depressive disorder?

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-02-01 DOI:10.1016/j.jpsychires.2025.01.008

Ò. Alcoverro-Fortuny , F. Viñas Usan , C. Elena Sanabria , J.E. Rojo Rodes

{"title":"How does the measurement of anesthetic depth using the patient state index influence the course of electroconvulsive therapy in patients with major depressive disorder?","authors":"Ò. Alcoverro-Fortuny , F. Viñas Usan , C. Elena Sanabria , J.E. Rojo Rodes","doi":"10.1016/j.jpsychires.2025.01.008","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Determining anesthetic depth has been used to assess the optimal timing of electrical stimulus application in electroconvulsive therapy (ECT). This has improved the quality and effectiveness of seizures, as some anesthetics used can decrease efficacy. This study evaluated the influence of the Patient State Index (PSi) on the course of ECT in patients with major depressive disorder (MDD).</div></div><div><h3>Methods</h3><div>this was an experimental prospective study with a control group involving 47 patients (22 assessed with the PSi, 25 controls) admitted and diagnosed with MDD. Clinical evolution variables, procedural characteristics, cognitive variables, and seizure adequacy were analyzed using mixed-effects linear models and Kaplan-Meier survival curves.</div></div><div><h3>Results</h3><div>the PSi group had fewer restimulations during treatment, higher values of seizure concordance, and higher \"time to peak coherence\" as parameters of seizure quality. No significant differences were observed between the two groups regarding improvement in depression, intra-ECT awareness, or adverse cognitive effects.</div></div><div><h3>Conclusion</h3><div>the use of the PSi for measuring anesthetic depth in modified ECT with propofol appeared to improve procedure effectiveness without increasing the incidence of intra-ECT awareness or cognitive side effects.</div></div>","PeriodicalId":16868,"journal":{"name":"Journal of psychiatric research","volume":"182 ","pages":"Pages 59-65"},"PeriodicalIF":3.7000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of psychiatric research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022395625000081","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Determining anesthetic depth has been used to assess the optimal timing of electrical stimulus application in electroconvulsive therapy (ECT). This has improved the quality and effectiveness of seizures, as some anesthetics used can decrease efficacy. This study evaluated the influence of the Patient State Index (PSi) on the course of ECT in patients with major depressive disorder (MDD).

Methods

this was an experimental prospective study with a control group involving 47 patients (22 assessed with the PSi, 25 controls) admitted and diagnosed with MDD. Clinical evolution variables, procedural characteristics, cognitive variables, and seizure adequacy were analyzed using mixed-effects linear models and Kaplan-Meier survival curves.

Results

the PSi group had fewer restimulations during treatment, higher values of seizure concordance, and higher "time to peak coherence" as parameters of seizure quality. No significant differences were observed between the two groups regarding improvement in depression, intra-ECT awareness, or adverse cognitive effects.

Conclusion

the use of the PSi for measuring anesthetic depth in modified ECT with propofol appeared to improve procedure effectiveness without increasing the incidence of intra-ECT awareness or cognitive side effects.

查看原文本刊更多论文

使用患者状态指数测量麻醉深度如何影响重性抑郁症患者电休克治疗的过程？

背景：确定麻醉深度已被用于评估电痉挛治疗（ECT）中电刺激应用的最佳时机。这提高了癫痫发作的质量和有效性，因为使用的一些麻醉剂会降低疗效。本研究评估患者状态指数（PSi）对重度抑郁障碍（MDD）患者电痉挛治疗过程的影响。方法：这是一项试验性前瞻性研究，对照组包括47例患者（22例接受PSi评估，25例对照组）入院并诊断为重度抑郁症。使用混合效应线性模型和Kaplan-Meier生存曲线分析临床进化变量、程序特征、认知变量和癫痫发作充分性。结果：PSi组在治疗期间的再刺激较少，癫痫发作一致性值较高，癫痫发作质量参数“至峰连贯时间”较高。在抑郁改善、ect内意识或不良认知影响方面，两组间无显著差异。结论：在异丙酚改良ECT中，使用PSi测量麻醉深度似乎可以提高手术效率，而不会增加ECT内意识或认知副作用的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;