Journal of Ect最新文献

{"title":"\"To the Editor: Demonstrating Continued Safety With Right-Unilateral Electroconvulsive Therapy in a Patient With an Intracranial Implantable Device\".","authors":"Justin J Pomeroy, Catherine Bledowski, Jozef Bledowski","doi":"10.1097/YCT.0000000000001133","DOIUrl":"10.1097/YCT.0000000000001133","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"e58-e59"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063282","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}

{"title":"Is There an Optimal Electrode Placement for Patients With Schizophrenia Undergoing Electroconvulsive Therapy?","authors":"Weng Jun Tan, Kimberly Wan Xin Choo, Jenies Hui Xin Foo, Phern Chern Tor","doi":"10.1097/YCT.0000000000001108","DOIUrl":"10.1097/YCT.0000000000001108","url":null,"abstract":"<p><strong>Abstract: </strong>Electroconvulsive therapy (ECT) is a recognized treatment option for patients with schizophrenia, especially when patients do not respond adequately to antipsychotic medication or when rapid response is needed in severe cases. The 3 common electrode placements, namely, bitemporal, bifrontal and right unilateral (RUL) modalities, have all been described by various studies to be efficacious in symptom reduction. However, the optimal electrode placement with the greatest success rate in the treatment of schizophrenia has yet to be ascertained. Furthermore, the benefit of switching ECT modalities after poor response to the initial electrode placement has not been well studied. Hence, to illustrate the twin issues of the optimal ECT modality as well as the effect of switching ECT modalities after initial nonresponse in patients with schizophrenia, we describe 2 distinct patients who underwent multiple courses of bifrontal and RUL ECT, but only responded well to bifrontal ECT. This is possibly due to the patients' anatomical differences as well as varying brain stimulation patterns produced by the different electrode placements. Thus, we believe that the prescription of ECT in patients with schizophrenia should be individualized, and a switch to a different ECT modality should be strongly considered if there is a lack of response to a particular modality.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"289-291"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191166","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}

{"title":"Catatonia in a Patient With Lissencephaly Treated With ECT: A Case Report and Literature Review.","authors":"Yassir Mahgoub, Moyyed Khalid, Wafa Sosal, Aum Pathare","doi":"10.1097/YCT.0000000000001117","DOIUrl":"10.1097/YCT.0000000000001117","url":null,"abstract":"<p><strong>Abstract: </strong>Catatonia is a neuropsychiatric syndrome that occurs with several psychiatric and systemic medical conditions. Central nervous system abnormalities are believed to increase the risk of catatonia, with several cases reported in patients with neurodevelopmental and neurodegenerative disorders. Lissencephaly is a spectrum of neuronal migration disorders characterized by poorly defined or absent gyri and sulci, abnormally thick cortex, and a broad array of histopathological changes. Lissencephaly has a range of etiologies, clinical signs, symptoms, and degrees of severity. It is associated with comorbidities, such as epilepsy, visual, cardiac, and skeletal problems, as well as premature mortality.In this article, we describe the case of a patient with lissencephaly who developed catatonia at 20 years of age. He was minimally responsive to treatment with a high dose of lorazepam, and catatonia subsided with the use of electroconvulsive therapy. This is the first case in our knowledge to describe the occurrence of catatonia among patients with lissencephaly and its treatment with electroconvulsive therapy.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"e55-e57"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528038","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}

{"title":"Computational Models of High-Definition Electroconvulsive Therapy for Focal or Multitargeting Treatment.","authors":"Niranjan Khadka, Zhi-De Deng, Sarah H Lisanby, Marom Bikson, Joan A Camprodon","doi":"10.1097/YCT.0000000000001069","DOIUrl":"10.1097/YCT.0000000000001069","url":null,"abstract":"<p><strong>Abstract: </strong>Attempts to dissociate electroconvulsive therapy (ECT) therapeutic efficacy from cognitive side effects of ECT include modifying electrode placement, but traditional electrode placements employing 2 large electrodes are inherently nonfocal, limiting the ability to selectively engage targets associated with clinical benefit while avoiding nontargets associated with adverse side effects. Limited focality represents a technical limitation of conventional ECT, and there is growing evidence that the spatial distribution of the ECT electric fields induced in the brain drives efficacy and side effects. Computational models can be used to predict brain current flow patterns for existing and novel ECT montages. Using finite element method simulations (under quasi-static, nonadaptive assumptions, 800-mA total current), the electric fields generated in the superficial cortex and subcortical structures were predicted for the following traditional ECT montages (bilateral temporal, bifrontal, right unilateral) and experimental montages (focal electrically administered seizure therapy, lateralized high-definition [HD]-ECT, unilateral 4 × 1-ring HD-ECT, bilateral 4 × 1-ring HD-ECT, and a multipolar HD-ECT). Peak brain current density in regions of interest was quantified. Conventional montages (bilateral bifrontal, right unilateral) each produce distinct but diffuse and deep current flow. Focal electrically administered seizure therapy and lateralized HD-ECT produce unique, lateralized current flow, also impacting specific deep regions. A 4 × 1-ring HD-ECT restricts current flow to 1 (unilateral) or 2 (bilateral) cortical regions. Multipolar HD-ECT shows optimization to a specific target set. Future clinical trials are needed to determine whether enhanced control over current distribution is achieved with these experimental montages, and the resultant seizures, improve the risk/benefit ratio of ECT.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"223-231"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12892304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma microRNA Levels After Electroconvulsive Therapy in Treatment-Resistant Depressed Patients.","authors":"Chiara Galbiati, Vincenzo Dattilo, Marco Bortolomasi, Erika Vitali, Maria Abate, Valentina Menesello, Mattia Meattini, Rosana Carvalho Silva, Massimo Gennarelli, Luisella Bocchio Chiavetto, Alessandra Minelli","doi":"10.1097/YCT.0000000000001100","DOIUrl":"10.1097/YCT.0000000000001100","url":null,"abstract":"<p><strong>Objectives: </strong>Electroconvulsive therapy (ECT) is one of the most effective treatments for treatment-resistant depression (TRD), even though the molecular mechanisms underlying its efficacy remain largely unclear. This study aimed, for the first time, to analyze plasma levels of miRNAs, key regulators of gene expression, in TRD patients undergoing ECT to investigate potential changes during treatment and their associations with symptom improvement.</p><p><strong>Methods: </strong>The study involved 27 TRD patients who underwent ECT. Plasma samples were collected at baseline (T0) and 1 month after the last ECT session (T1), and miRNA analysis was conducted by qRT-PCR. We also performed gene prediction of miRNAs differentially expressed and KEGG pathway analysis.</p><p><strong>Results: </strong>miR-95-3p, miR-194-5p, miR-324-3p, miR-195-5p, miR-19b-3p, miR-30c-5p, let-7i-5p, and miR-497-5p were nominally downregulated at T1. Changes in miR-324-3p and miR-30c-5p levels between T0 and T1 significantly correlated with symptom improvement. Among the predicted miRNA target genes of these 2 miRNAs, we noticed the presence of VEGF and SIRT1, whose expression regulation has been associated with the ECT mechanism of action in previous studies.</p><p><strong>Conclusions: </strong>The study's most relevant results are related to the correlation between reductions in miR-30c-5p and miR-324-3p and the improvement of symptoms in response to ECT, positioning these miRNAs as promising candidates for further studies. These findings support and extend previous clinical and preclinical research indicating a role of miRNAs in ECT mechanism of action. However, no significant effects in ECT miRNA modulation were observed, highlighting the need for future replications in broader samples to confirm these results.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"232-237"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962538","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}

{"title":"Maintenance Electroconvulsive Therapy for Treatment-Resistant Irritability in Autism Due to Depression in an Adolescent: A Case Study.","authors":"Enes Faruk Altunkilic, Gul Karacetin, Ipek Ege Gurel Ficicioglu, Ezgi Gurtay, Binay Kayan Ocakoglu, Aysegul Tonyali","doi":"10.1097/YCT.0000000000001118","DOIUrl":"10.1097/YCT.0000000000001118","url":null,"abstract":"<p><strong>Abstract: </strong>Irritability may be seen in patients with autism spectrum disorder, and it may be treated medically. The core features of the ASD diagnosis may confound presumed treatment resistance of irritability in ASD. Mood disorders should be in differential diagnosis if irritability is treatment-resistant in patients with autism. Electroconvulsive therapy (ECT) may be an effective treatment of choice in such patients. In this case report, we present a 16-year-old, 10-month-old male adolescent with autism spectrum disorder who was admitted to our inpatient service due to his self-harming and aggressive behavior with the possibility of severe harm resulting to others. His irritability was resistant to medical treatment; therefore, an underlying mood disorder was considered in the differential diagnosis. This case report presents a patient with treatment-resistant irritability in autism who was treated with fluoxetine and ECT. ECT is being continued as maintenance ECT. While this case is being written, he has received 36th maintenance ECT at a frequency of twice a week. This patient has benefited from a combination of fluoxetine and ECT. In conclusion, in the presence of irritability unresponsive to pharmacological and behavioral treatment in a patient with nonverbal autism spectrum disorder, an underlying mood disorder should be considered, and treatment should be arranged accordingly; ECT and maintenance ECT may be an effective treatment option.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"292-297"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442858","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}

{"title":"Case Report: Rapid Improvement of Noncatatonic Mutism in a Patient With Schizophrenia by Electroconvulsive Therapy.","authors":"Daniel Loeffler, Ilana Regenbogen-Li, Alan S Lewis","doi":"10.1097/YCT.0000000000001153","DOIUrl":"10.1097/YCT.0000000000001153","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"e61-e63"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006437","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}

{"title":"Electroconvulsive Therapy in the Treatment of Clinical Zoanthropy With Comorbid Parkinson's Disease: A Case Report.","authors":"Lore Van de Voorde, Pieter-Jan Geerts, Gilbert Lemmens","doi":"10.1097/YCT.0000000000001160","DOIUrl":"10.1097/YCT.0000000000001160","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"e63-e64"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163863","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}

{"title":"Molecular Positron Emission Tomography and Single-Photon Emission Computed Tomography Imaging for Understanding the Neurobiological Mechanisms of Electroconvulsive Therapy: A Scoping Review.","authors":"Maarten Laroy, Koen Van Laere, Mathieu Vandenbulcke, Louise Emsell, Filip Bouckaert","doi":"10.1097/YCT.0000000000001094","DOIUrl":"10.1097/YCT.0000000000001094","url":null,"abstract":"<p><strong>Abstract: </strong>Electroconvulsive therapy (ECT) effectively treats severe psychiatric disorders such as depression, mania, catatonia, and schizophrenia. Although its exact mechanism remains unclear, ECT is thought to induce neurochemical and neuroendocrine changes. Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) have provided vital insights into ECT's neurobiological effects. This scoping review investigates the role of molecular imaging in understanding these effects. A systematic search across PubMed, EMBASE, Web of Science, Cochrane, and Scopus databases yielded 857 unique records, from which 45 peer-reviewed articles in English with longitudinal PET or SPECT measures in ECT patients were included. The review identifies 2 main research directions: ECT's impact on brain activity and neurotransmitters. Initial research assessed regional cerebral blood flow and regional glucose metabolism during ictal (during ECT), postictal (within 24 hours), short-term (within a week), and long-term (beyond a week) follow-up as markers of brain activity. Initial findings showed an anterior-posterior regional cerebral blood flow gradient during the ictal phase, with subsequent normalization of hypoperfusion in frontal and parietal regions, and persistent long-term effects. Later, research shifted to the monoamine hypothesis of depression, examining ECT's impact on serotonin and dopamine systems via PET imaging. Results on receptor availability post-ECT were mixed, showing both reductions and no significant changes, indicating variable effects. This scoping review further highlights the need to explore new targets, tailor methodologies for patient populations, and foster multicenter studies. Although SPECT has been valuable, advances in PET imaging now make it preferable, offering unparalleled insights into ECT's molecular and neurobiological mechanisms.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"268-280"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Cognitive Impact and Treatment Efficacy: A Single-Blind Randomized Controlled Trial Comparing Brief Pulse and Ultra-Brief Pulse ECT in Schizophrenia Patients.","authors":"Upasana Rai, Surendra Paliwal, Surjit Prasad, Gulesh Kumar, Pranjal Dey, Varun S Mehta","doi":"10.1097/YCT.0000000000001210","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001210","url":null,"abstract":"<p><strong>Background: </strong>Electroconvulsive therapy (ECT) is a widely used treatment for schizophrenia, particularly for acute psychosis, treatment resistance, severe self-harm, and catatonia. Modifying pulse width to a brief pulse (0.5 to 2.0 ms) has emerged as a promising method to minimize adverse cognitive effects traditionally associated with ECT. Newer ECT devices allow shorter stimulus, termed ultra-brief pulse (<0.5 ms). However, the available literature lacks sufficient comparative trials assessing the differences in cognitive adverse effects and clinical efficacy between brief pulse and ultra-brief pulse ECT in patients with schizophrenia.</p><p><strong>Aim: </strong>To test if there is a significant difference between cognitive adverse effects and efficacy of ultra-brief pulse and brief pulse bitemporal ECT.</p><p><strong>Methods: </strong>A prospective, hospital-based, randomized single-blind design was used. Forty-two patients diagnosed with schizophrenia were randomly allocated to ultra-brief pulse (0.3 ms) and brief pulse (0.5 ms) bitemporal ECT groups. ECT was administered thrice weekly under anaesthesia, at 2.5 times the seizure threshold. Clinical efficacy and cognitive functioning were assessed using PANSS, CGI, CDSS, MMSE, and Hindi MoCA, both at baseline and following 1 to 2 days after the first and eighth ECT sessions.</p><p><strong>Results: </strong>Forty patients completed the study. Both groups showed a significant reduction in PANSS subscale scores over time, with no significant difference between them. Similarly, while MoCA and MMSE scores changed significantly within each group, no group-wise difference was found regarding cognitive side effects.</p><p><strong>Conclusions: </strong>Ultra-brief pulse bitemporal ECT does not confer significant advantages over brief pulse bitemporal ECT in terms of cognitive side effects or efficacy in schizophrenia.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716892","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}