Journal of Ect最新文献

Effective Use of ECT for Catatonia Associated With Postpartum Acute Demyelinating Syndrome. ECT治疗产后急性脱髓鞘综合征紧张症的有效应用。

IF 1.8 4区医学

Journal of Ect Pub Date : 2026-04-17 DOI: 10.1097/YCT.0000000000001239

Astha Jain, Shobit Garg, Nitin Garg

引用次数: 0

Differential Factor-Level MADRS Response Associated With Seizure Duration in Electroconvulsive Therapy: Exploratory Findings. 电休克治疗中与癫痫持续时间相关的差异因子水平的MADRS反应：探索性发现。

IF 1.8 4区医学

Journal of Ect Pub Date : 2026-04-17 DOI: 10.1097/YCT.0000000000001264

Kevin Swierkosz-Lenart, Setareh Ranjbar, Charline Compagne, Jean-Frédéric Mall, Armin von Gunten, Pierre Vandel, Beatriz Pozuelo Moyano

{"title":"Differential Factor-Level MADRS Response Associated With Seizure Duration in Electroconvulsive Therapy: Exploratory Findings.","authors":"Kevin Swierkosz-Lenart, Setareh Ranjbar, Charline Compagne, Jean-Frédéric Mall, Armin von Gunten, Pierre Vandel, Beatriz Pozuelo Moyano","doi":"10.1097/YCT.0000000000001264","DOIUrl":"10.1097/YCT.0000000000001264","url":null,"abstract":"Background: Electroconvulsive therapy (ECT) is a widely used treatment for severe and treatment-resistant depression, with high efficacy but considerable interindividual variability of response. The neurophysiological mechanisms underlying ECT's antidepressant effects, particularly the role of seizure duration, remain unclear. This exploratory study investigates how EEG-measured seizure duration influences depressive symptomatology.Methods: We retrospectively analyzed data from 53 participants with depressive symptoms (MADRS ≥21) who underwent ECT at the interventional psychiatry unit of the Lausanne University Hospital (CHUV) between November 2023 and April 2025. MADRS scores were assessed at baseline and 6 weeks after ECT. Seizure duration was categorized into 3 groups: short (25 to 39 s), medium (40 to 59 s), and long (≥60 s). Statistical tests, including the Kruskal-Wallis and multiple linear regression, were performed to assess the differences in MADRS score changes across these groups. In addition, we conducted exploratory analyses at the symptom cluster level in MADRS score changes.Results: Participants in the medium seizure duration group (40 to 59 s) exhibited the greatest overall improvement in MADRS scores, including a significant reduction in the anxiety and vegetative symptoms cluster. In contrast, for affective and anhedonic symptoms and hopelessness symptoms, the difference between the seizure duration categories did not reach statistical significance.Conclusion: This study identifies an optimal seizure duration window (40 to 59 s) as most effective in reducing symptom severity, as measured by MADRS and its symptom cluster factors. Further research is needed to better understand the complex relationship between seizure dynamics and ECT outcomes.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of 4 Methods to Estimate the Resting Motor Threshold Using Transcranial Magnetic Stimulation: Rossini-Rothwell, 2-Threshold, Adaptive Threshold Hunting, and Stimulus-Response Curve Approaches. 经颅磁刺激估计静息运动阈值的4种方法的比较：Rossini-Rothwell， 2-Threshold， Adaptive Threshold Hunting和刺激-反应曲线法。

IF 1.8 4区医学

Journal of Ect Pub Date : 2026-04-08 DOI: 10.1097/YCT.0000000000001211

Ashok Jammigumpula, Jithin T Joseph, Abhiram N Purohith, Sonia Shenoy, Samir Kumar Praharaj

{"title":"Comparison of 4 Methods to Estimate the Resting Motor Threshold Using Transcranial Magnetic Stimulation: Rossini-Rothwell, 2-Threshold, Adaptive Threshold Hunting, and Stimulus-Response Curve Approaches.","authors":"Ashok Jammigumpula, Jithin T Joseph, Abhiram N Purohith, Sonia Shenoy, Samir Kumar Praharaj","doi":"10.1097/YCT.0000000000001211","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001211","url":null,"abstract":"Background: Estimating the resting motor threshold (RMT) is crucial for both investigative and therapeutic transcranial magnetic stimulation. However, no gold standard exists, as each method involves trade-offs between accuracy, time, and ease of use. This study compared RMT estimates and trial requirements across 4 EMG-based methods-Rossini-Rothwell (RR), maximum likelihood parameter estimation by sequential testing (ML-PEST), Mills-Nithi (MN), supervised parametric estimation (SPE)-and 2 visual methods: RR visual and ML-PEST visual.Methods: In this observational study, RMT was estimated in 20 healthy participants using 6 approaches: 4 EMG-based (RR, ML-PEST, MN, SPE) and 2 visual (RR and ML-PEST). We assessed agreement among EMG-based methods and compared RMT estimates and trial counts across all methods.Results: EMG-based methods showed strong agreement (ICC: 0.97, 95% CI: 0.94-0.99). RMT estimates differed significantly (P=0.001), with RR Visual yielding the highest values-significantly higher than RR EMG, ML-PEST EMG, and SPE EMG methods. Trial counts also varied (P<0.001), with ML-PEST requiring the fewest. In subgroup analysis, RR Visual and ML-PEST Visual produced similar RMTs, but ML-PEST Visual needed fewer trials.Conclusions: Adaptive threshold-hunting methods like ML-PEST offer efficient and accurate RMT estimation while reducing the number of required trials, supporting their use in both clinical and research applications.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Use of Ports for Intravenous Access in Electroconvulsive Therapy. 电休克治疗中静脉通路的使用。

IF 1.8 4区医学

Journal of Ect Pub Date : 2026-04-03 DOI: 10.1097/YCT.0000000000001270

Shami A Entenman, Daniel F Maixner

{"title":"The Use of Ports for Intravenous Access in Electroconvulsive Therapy.","authors":"Shami A Entenman, Daniel F Maixner","doi":"10.1097/YCT.0000000000001270","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001270","url":null,"abstract":"Electroconvulsive therapy (ECT) is a procedure to treat complex psychiatric conditions and requires serial treatments. Patients may undergo twelve or more treatments acutely and many continue maintenance ECT for longer-term management. Intravenous (IV) access is necessary to administer medications during ECT, including those for anesthesia, muscle relaxation, and blood pressure management. Peripheral IV access can become challenging over time due to repeated IV insertions and/or poor venous access. Many patients in our ECT cohort are recommended to have a port, a totally implantable venous-access device, placed to facilitate IV access during their treatment course. We conducted a 5-year chart review to evaluate the demographics of patients who received a port in our ECT cohort and to better understand the possible complications of port placement. Thirty-nine ECT patients were identified as having IV port placement during the 5-year study period. Port placement was more common in females, younger patients, those with catatonia, and patients receiving longer-term or maintenance ECT. There was a low rate of serious complications, and no fatalities were associated with having a port. We conclude that the use of ports is a safe and important option for IV access, especially in patients receiving maintenance ECT.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Enemy of Good Is Not Precision: Advancing Contemporary Electroconvulsive Therapy Practice. 善的敌人不是精确：推进当代电休克治疗实践。

IF 1.8 4区医学

Journal of Ect Pub Date : 2026-04-03 DOI: 10.1097/YCT.0000000000001262

Christopher C Abbott, Abhishek Datta, Zhi-De Deng

引用次数: 0

Electroconvulsive Therapy Following Transmastoid Repair of a Skull-Base Defect and Cerebrospinal Fluid Leak: A Case Report. 经乳突修补颅底缺损及脑脊液漏后电休克治疗1例报告。

IF 1.8 4区医学

Journal of Ect Pub Date : 2026-04-01 DOI: 10.1097/YCT.0000000000001269

Muhammad Munshi, Nofrat Schwartz, Marcus Hughes

引用次数: 0

Vagus Nerve Stimulation, Kindling, and Neuroprogression in Recurrent Depression. 复发性抑郁症的迷走神经刺激、点燃和神经进展。

IF 1.8 4区医学

Journal of Ect Pub Date : 2026-03-30 DOI: 10.1097/YCT.0000000000001268

Tommaso Toffanin, Giorgio Pigato, Giulia Ida Perini, Luigi Grassi, Fabio Sambataro

引用次数: 0

Electroconvulsive Therapy and the Longitudinal Modulation of Sleep Architecture. 电痉挛疗法和睡眠结构的纵向调节。

IF 1.8 4区医学

Journal of Ect Pub Date : 2026-03-27 DOI: 10.1097/YCT.0000000000001265

Mohammad Mehdi Kafashan, Lucas Lebovitz, Zitian Zhou, Subha Subramanian, Alyssa K Labonte, Robby Greenspan, Nan Lin, Yo-El S Ju, Ben Julian A Palanca, Nuri B Farber

{"title":"Electroconvulsive Therapy and the Longitudinal Modulation of Sleep Architecture.","authors":"Mohammad Mehdi Kafashan, Lucas Lebovitz, Zitian Zhou, Subha Subramanian, Alyssa K Labonte, Robby Greenspan, Nan Lin, Yo-El S Ju, Ben Julian A Palanca, Nuri B Farber","doi":"10.1097/YCT.0000000000001265","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001265","url":null,"abstract":"Background: Sleep plays a critical role in mood regulation, yet the mechanisms linking sleep to mood improvement remain unclear. Electroencephalographic (EEG) slow-wave activity (SWA) during non-rapid eye movement (NREM) sleep is reduced in patients with major depressive disorder. Here, we examined sleep architecture in patients with depression undergoing electroconvulsive therapy (ECT).Methods: Sleep EEG data were collected using wireless Dreem devices before and after each ECT session serially throughout the ECT course. Sleep stages were manually scored into rapid eye movement (REM) and NREM stages (N1-N3) according to modified American Academy of Sleep Medicine guidelines. Depression severity was assessed using the 16-Item Quick Inventory of Depressive Symptomatology-Self Report (QIDS). SWA was quantified as the average 0.5-4 Hz frontal EEG power per minute during N2 and N3 sleep.Results: Across 214 sleep records from 22 subjects (median 9 per patient), the percentage of time in N3 sleep increased over the course of therapy in the responders' group (P=0.030). SWA increased throughout the ECT course across all participants (P=0.001), and it was negatively correlated with the QIDS score (P<0.001). Mediation analysis revealed that SWA mediated the effect of treatment on QIDS only in the responders' group (P=0.037).Conclusion: Our findings demonstrate that ECT increases N3 sleep and SWA in the responders' group, with SWA changes mediating improvements in depressive symptoms. These findings highlight SWA as a biomarker of antidepressant response and a potential target for sleep-based strategies to augment brain stimulation therapies for depression.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictors of Postictal Delirium Following Electroconvulsive Therapy in a Sample of Patients With Schizophrenia: An Egyptian Experience. 精神分裂症患者电休克治疗后谵妄的预测因素：埃及经验。

IF 1.8 4区医学

Journal of Ect Pub Date : 2026-03-23 DOI: 10.1097/YCT.0000000000001267

Tarek Okasha, Sherin Khalil, Rehab Serag, Shaimaa Abdelhamid, Omar Mansour

{"title":"Predictors of Postictal Delirium Following Electroconvulsive Therapy in a Sample of Patients With Schizophrenia: An Egyptian Experience.","authors":"Tarek Okasha, Sherin Khalil, Rehab Serag, Shaimaa Abdelhamid, Omar Mansour","doi":"10.1097/YCT.0000000000001267","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001267","url":null,"abstract":"Purpose: Electroconvulsive therapy (ECT) is recognized as an effective treatment for patients with schizophrenia. However, it is sometimes followed by adverse effects that are usually self-limiting. Postictal delirium (PID) is an adverse effect that is difficult to predict and requires further study.Patients and methods: An observational cross-sectional study was conducted on patients with schizophrenia receiving ECT. The selected patients underwent the Delirium Observation Scale and Mini-Mental State Examination. Also, clinical characteristics and ECT-related variables were included in the study.Results: A total of N=69 patients were included in the study. The ages ranged from 18 to 55 years, with a mean age of 34.5 years; 60.8% (N=42) were males. Among males, just over half (54.7%) smoked tobacco. BMI indicated that most participants fell within the normal to overweight range. There were no significant differences between patients with and without PID in terms of age, BMI, medical comorbidity, either first-generation or second-generation antipsychotics, and ECT stimulus dose. However, use of clozapine, anticholinergic medications, a combination of first-generation and second-generation antipsychotics, presence of catatonia, smoking, longer seizure duration, and a 1-day gap between sessions were associated with PID.Conclusion: Regression analysis identified several clinical and treatment features associated with PID development. Prevention strategies may be targeted to these factors.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of Anesthesia in ECT for Major Depressive Disorder. 麻醉在ECT治疗重度抑郁症中的作用。

IF 1.8 4区医学

Journal of Ect Pub Date : 2026-03-19 DOI: 10.1097/YCT.0000000000001259

Jennifer Sjödin, Karin Zimmer, Max Bell, Mikael Tiger

{"title":"Role of Anesthesia in ECT for Major Depressive Disorder.","authors":"Jennifer Sjödin, Karin Zimmer, Max Bell, Mikael Tiger","doi":"10.1097/YCT.0000000000001259","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001259","url":null,"abstract":"Electroconvulsive therapy (ECT) is an established treatment of major depressive disorder (MDD), particularly in severe cases and in cases resistant to pharmacological interventions. Anesthesia plays an important role in optimizing patient tolerability during ECT but may attenuate the treatment effect, as anesthetic agents elevate the seizure threshold. This review aims to examine the impact of commonly used anesthetics as well as the timing and dosing of anesthetics on seizure dynamics, patient safety and tolerability, and clinical outcomes of ECT for MDD. A systematic search was conducted in PubMed on September 23, 2024. Keywords included \"anesthesia,\" \"ECT,\" and \"depression.\" Fifty-nine clinical trials, observational studies and meta-analyses were selected for in-depth analysis. We found that ketamine and etomidate are associated with longer seizures than other anesthetic agents. The use of etomidate is limited by its suppression of the adrenal synthesis of cortisol. Ketamine can, to a greater extent than other anesthetics, cause depersonalization, derealization, and audio-visual perceptual alterations. Lower doses of anesthesia and longer intervals between anesthetic administration and ECT have been related to longer seizures and also increased likelihood of response to ECT for MDD, although this has not yet been demonstrated in randomized controlled trials. Clinical outcomes are generally similar among different anesthetics, though ketamine anesthesia is associated with a more rapid effect of ECT. The choice of an anesthetic should be based on patient-specific factors such as cardiovascular health. Further research on optimized anesthetic dosing and timing is needed, especially with a focus on the clinical outcome of ECT.","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0