Journal of Ect最新文献

{"title":"Safety and Efficacy of Continuous Theta Burst \"Intensive\" Posterior Parietal Cortex Stimulation in Generalized Anxiety Disorder: A Randomized Double-Blind Sham-Controlled Trial.","authors":"Sarthak Bhandari, Mohan Dhyani, Shobit Garg, Sai Krishna Tikka","doi":"10.1097/YCT.0000000000001131","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001131","url":null,"abstract":"<p><strong>Objectives: </strong>Citing nonresponse to conventional treatments, neuromodulation based treatments are needed in generalized anxiety disorder (GAD). Data regarding continuous TBS (cTBS) in GAD has been anecdotal. Citing right posterior parietal cortex (PPC) hyperconnectivity in GAD, we aimed to study the effect of intensive cTBS targeting PPC in a randomized rater-blinded placebo-control design.</p><p><strong>Material and methods: </strong>Forty-four patients age range 18-59 years (baseline Hamilton Anxiety Rating Scale [HAM-A] score >18 or Clinical Global Impression Severity [CGI-S] score of ≥4) were randomly allocated to active cTBS (n = 22) and sham cTBS (n = 22) groups using block randomization method. They received 10 cTBS sessions, 2 sessions per day (total of 1200 pulses) for 5 days in a week at 80% motor threshold. HAM-A, World Health Organization's abbreviated quality of life assessment (WHOQOL-BREF), and CGI-S were assessed at baseline, after the last session, and at 2 weeks after cTBS with gender as covariate. Intention-to-treat analysis was conducted and missing values were replaced using the last observation carried forward method.</p><p><strong>Results: </strong>On repeated measures analysis of variance, a significant between-group time effect for HAM-A (F = 29.6; P = 0.001; ηp2 = 0.420), CGI-S (F = 24.7; P = 0.001; ηp2 = 0.376), and WHOQOL-BREF (F = 29.6; P = 0.001; ηp2 = 0.420). Logs of odds of response of >50% improvement in HAM-A between active and sham groups is 3.27 (95% CI [0.345, 6.20]). No major side effects were reported and none discontinued the trial because of side effects.</p><p><strong>Conclusions: </strong>Our trial concludes that cTBS of posterior parietal cortex is safe, well-tolerated, and effective in GAD.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631084","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":"The Role of Brain Derived Neurotrophic Factor Polymorphism in Transcranial Magnetic Stimulation Response for Major Depressive Disorder.","authors":"Megan M Vigne, Jamie Kweon, Andrew M Fukuda, Joshua C Brown, Linda L Carpenter","doi":"10.1097/YCT.0000000000001123","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001123","url":null,"abstract":"<p><strong>Objectives: </strong>Repetitive transcranial magnetic stimulation (rTMS) is a safe and effective therapy for treatment-resistant depression (TRD). A crucial next step in improving rTMS therapy is to identify response predictors to inform patient selection criteria. Brain-derived neurotrophic factor (BDNF) exerts influence over TRD treatment modalities. BDNF polymorphism, Val66Met, has shown altered cortical plasticity after single-session rTMS in healthy subjects and clinical response in noninvasive brain stimulation methods in major depressive disorder, stroke, Alzheimer's, and cerebral palsy. We sought to evaluate the effect of this BDNF polymorphism on clinical response in a standard course of rTMS therapy for TRD.</p><p><strong>Methods: </strong>In this naturalistic study, 75 patients with TRD completed a standard course of rTMS with weekly clinical assessments via the Inventory of Depressive Symptomatology Self-Report (IDS-SR). BDNF polymorphisms were retrospectively compared in respect to treatment response and remission, baseline and final scores, percent change scores, and scores across the 6-week treatment course.</p><p><strong>Results: </strong>As expected, rTMS significantly decreased depressive symptoms as measured by IDS-SR scores. No difference was found in baseline, final, or percent change IDS-SR scores between polymorphism types. There was no difference between polymorphisms in IDS-SR scores across the treatment course. Response and remission rates did not differ between genotypes.</p><p><strong>Conclusions: </strong>In contrast to previous research highlighting differential response between BDNF polymorphisms to motor plasticity and clinical rTMS outcomes, our data suggest that BDNF polymorphism status may not influence the response to a standard course of 10-Hz rTMS for major depressive disorder. Differences in TMS protocol, target, or BDNF serum levels may underlie our results.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558796","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":"Revitalizing Lost Memories: Long-Term Swift Learning and Improvement Post Electroconvulsive Therapy: A Case Report.","authors":"Clara Massaneda-Tuneu, Colleen Loo, Donel Martin","doi":"10.1097/YCT.0000000000001116","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001116","url":null,"abstract":"<p><strong>Abstract: </strong>Although there is robust evidence of electroconvulsive therapy's (ECT's) efficacy in severe mental illnesses, its use is still constrained by patients' and clinicians' concern about the possibility of cognitive side effects. It is established that anterograde amnesia usually recovers within weeks of the acute ECT treatment course, whereas retrograde memory loss can persist in the long term in some patients. To date, it remains unknown whether retrograde memory loss after ECT can recover and, if so, how.This case report describes a patient who received an acute course of bifrontal 0.5 milliseconds ECT within a time frame of 6 months. The patient initially experienced significant memory loss, including anterograde and retrograde amnesia, the latter including knowledge and skills learnt from more than a decade prior to ECT. During the first year after the patient received ECT, her anterograde memory functioning recovered, but her retrograde memory loss remained. Notably, 2 years after the last ECT treatment, the patient observed an ability to rapidly relearn the material and skills that were lost after ECT. We believe that this case report will offer hope for patients who experience longer-term retrograde memory loss after ECT and stimulate new research on novel interventions for post ECT amnesia.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558794","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":"Family Presence During Electroconvulsive Therapy: A Qualitative Study About Its Feasibility From a Patient, Family Member, and Healthcare Worker Perspective.","authors":"Nele Van de Velde, Anke De Decker, Pieter-Jan Geerts, Sofie Verhaeghe, Hannelore Tandt, Pascal Sienaert, Marc Coppens, Gilbert Lemmens","doi":"10.1097/YCT.0000000000001132","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001132","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore perspectives of patients, family, and healthcare professionals on feasibility of family presence during electroconvulsive therapy (ECT).</p><p><strong>Methods: </strong>This qualitative study used semistructured interviews. Eleven patients and 12 healthcare workers participated in small focus groups. Four family members were interviewed individually. All patients and their family members had prior experience with ECT, and all healthcare workers provided care to patients undergoing ECT. Verbatim transcriptions were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Five main themes emerged. First, family members should be considered as partners in ECT care and their involvement is beneficial for patients, family, and healthcare workers. Second, patients can experience more support through family proximity immediately before and after ECT and during the ECT procedure by providing an added sense of control. Third, family presence can be stressful for family members as witnessing the procedure might be anxiety provoking. In addition, for healthcare workers, increased distress by feeling watched might negatively impact their professional performance. Fourth, all participants express the need for clear guidelines when implementing family presence during ECT. Fifth, more transparency through family presence might be helpful to dispel ECT myths still present in society.</p><p><strong>Conclusions: </strong>Even though family presence during an ECT procedure can be stressful for healthcare workers and families, it can be feasible when embedded in a broader family-centered ECT care including clear guidelines. Family presence may enhance patients' sense of support, improve understanding of ECT for both patients and family members, and help destigmatize the procedure.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558779","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":"More Than 8 Years of Maintenance Electroconvulsive Therapy Without Antipsychotic Medication for a Deficit Form of Schizophrenia.","authors":"Mounir Jaafari, Youssef Ouazzani Housni Touhami, Imane Boujguenna, Rachid Aalouane, Ismail Rammouz","doi":"10.1097/YCT.0000000000001120","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001120","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558782","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":"Use of Electroconvulsive Therapy in a University Psychiatric Hospital in Brazil.","authors":"Elaine Loureiro Pereira-Soares, Antonio Leandro Nascimento, Gabriel Caetano Dos Santos, Natia Horato, Antonio Egidio Nardi","doi":"10.1097/YCT.0000000000001129","DOIUrl":"10.1097/YCT.0000000000001129","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study were to describe the practice of electroconvulsive therapy (ECT) at the Institute of Psychiatry (IPUB) of the Federal University of Rio de Janeiro (UFRJ) from 2015 to 2019 and to compare it with previous years at the same institute and with international practices.</p><p><strong>Methods: </strong>Sociodemographic and epidemiological data, along with information on ECT and anesthetic techniques, were collected from the medical records of all patients who received ECT at IPUB-UFRJ between 2015 and 2019.</p><p><strong>Results: </strong>A total of 238 patients underwent 4110 ECT sessions during the study period. A slight predominance of female patients (55.9%) was observed. Most patients were aged between 21 and 40 years (46.2%). Over half of the patients were outpatients (63.4%), with bipolar affective disorder being the most common diagnosis, accounting for 35.7% of ECT indications. Consent for ECT was obtained from all patients. Most treatments (85.2%) were conducted during the acute phase of illness. The average number of ECT sessions per patient was 5.4. All patients received anesthesia, and no deaths or severe complications related to ECT occurred. Monitoring cognitive effects and discharge criteria were the responsibility of the attending physician.</p><p><strong>Conclusions: </strong>The practice of ECT at IPUB-UFRJ adhered to both local and international guidelines. There has been a notable shift in the utilization patterns of ECT at the institute compared to previous years. Standardized monitoring of cognitive effects and discharge criteria remains essential.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442802","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":"Multicenter Observational Study of Electroconvulsive Therapy in Japan.","authors":"Takeshi Sakayori, Ken Wada, Minoru Takebayashi, Satoshi Ueda, Akihiko Machino, Atsushi Yoshimura, Enami Sawayama, Fumi Maruyama, Haruka Tanabe, Hidehiko Takahashi, Hideki Azuma, Hiraki Koishikawa, Hiroki Ozawa, Kazuya Okuhira, Kazuyuki Yasuda, Koichi Miyakawa, Reiji Yoshimura, Shigeru Ozaki, Shin Yokoyama, Shinkichi Eto, Shoko Tomonaga, Shuichi Isomura, Tsukasa Nonomura, Yoshiro Okubo","doi":"10.1097/YCT.0000000000001031","DOIUrl":"10.1097/YCT.0000000000001031","url":null,"abstract":"<p><strong>Objectives: </strong>The present study is the first large-scale, multicenter survey on modified electroconvulsive therapy (ECT) in Japan. We aimed to comprehend the current implementation status of ECT based on the annual reports of 2016 from 21 facilities that were certified by the Japanese Society of General Hospital Psychiatry as ECT certified facilities and participated in this multicenter observational study.</p><p><strong>Methods: </strong>We investigated the distributions of diagnosis, gender, and age of patients receiving acute-phase ECT, and the efficacy, safety, and adverse events.</p><p><strong>Results: </strong>The number of patients receiving acute-phase ECT was 524. According to International Classification of Diseases, 10th Revision, 344 patients (65.6%) were diagnosed with mood disorders (F3), 156 patients (29.8%) were diagnosed with schizophrenia and with schizotypal and delusional disorders (F2), and 151 subjects were male and 334 subjects were female. The mean age of patients was 60.4 years (SD 15.9), and patients 60 years or older accounted for 57.9%. Efficacy did not significantly differ between diagnoses, nor between genders. However, the efficacy rate was significantly higher in elderly patients. In acute-phase ECT, 4 severe adverse events occurred.</p><p><strong>Conclusions: </strong>Our multicenter study confirmed that F3 (mood disorders) was the most common indication for ECT at 66%, followed by F2 (schizophrenia, schizotypal, and delusional disorders) at 30%, with no difference in efficacy, indicating that ECT is still performed as 1 of the treatment options for schizophrenia in Japan. The present results suggested that accumulation of annual data from multiple centers can be useful for more effective and safer ECT practices.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":"41 1","pages":"31-36"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494951","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":"Reliable Change Indices and Minimum Detectable Change for the Montreal Cognitive Assessment in Electroconvulsive Therapy for Depression.","authors":"Emma Whooley, Gabriele Gusciute, Keeva Kavanagh, Kelly McDonagh, Cathal McCaffrey, Eimear Doody, Ana Jelovac, Declan M McLoughlin","doi":"10.1097/YCT.0000000000001043","DOIUrl":"10.1097/YCT.0000000000001043","url":null,"abstract":"<p><strong>Objective: </strong>The Montreal Cognitive Assessment (MoCA) is a commonly used brief cognitive screening tool for monitoring adverse cognitive effects of electroconvulsive therapy (ECT). The aim of this study was to examine three statistical methods for detecting reliable change in the MoCA following ECT.</p><p><strong>Methods: </strong>In a prospective cohort study, 47 patients (mean age 55.2 [SD = 12.8], 59.6% female) with unipolar or bipolar depression treated with an acute course of brief-pulse ECT (72.3% right unilateral) and 47 depressed controls without ECT exposure were tested on the MoCA at baseline and retested at comparable time intervals. ECT patients' performance was also compared to published normative data from a community-based sample of older adults. We calculated proportions of ECT patients remaining stable, declining, and improving following ECT using practice-corrected reliable change index, standardized regression-based formulas, and minimum detectable change cutoff of ±4 MoCA points.</p><p><strong>Results: </strong>Using the three methods, 72.3%-78.7% of ECT patients remained stable, 17.0%-23.4% declined, and 4.3% improved in MoCA performance following ECT compared to the two control groups.</p><p><strong>Conclusions: </strong>All three methods yield consistent estimates of reliable change in MoCA scores from pre- to post-brief-pulse ECT. The minimum detectable change approach may be the most efficient and accessible method of detecting change due to simplicity of calculation.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"43-48"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538962","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":"Importance of Multispecialty Coordination of Care in an Electroconvulsive Therapy Patient With Musculoskeletal, Neurological, and Vascular Injuries: A Case Report.","authors":"Hong M Lee, Michael D Kisicki, Jennifer Hong, Julia C Knight","doi":"10.1097/YCT.0000000000001037","DOIUrl":"10.1097/YCT.0000000000001037","url":null,"abstract":"<p><strong>Abstract: </strong>Electroconvulsive therapy (ECT) is considered an effective therapy for patients suffering from severe, life-threatening, intractable depression. This treatment modality delivers controlled electrical currents (typically no more than 100 J) under general anesthesia to induce seizure. Although generally considered to have a high safety profile, physiological changes induced during the ictal phase of ECT, such as elevation in blood pressure and intracranial pressure, impose additional risks to patients with concomitant cardiovascular or cerebrovascular conditions. We describe the successful use of ECT in a unique case complicated by a combination of acute vertebral artery dissection, traumatic intracerebral hemorrhage, and cervical spine injury sustained from a suicide attempt by intentional motor vehicle collision. Although ECT can be safely administered in the presence of recent vertebral artery dissection and traumatic intraparenchymal hemorrhage, an emphasis on multispecialty coordination is crucial to monitor and reduce the risk of elevated blood pressure and further cervical spine injury.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"71-73"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538960","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":"Preliminary Guidelines for Resuming Electroconvulsive Therapy After a Complication of Status Epilepticus.","authors":"Maya Hazimeh, Nicholas Arnoudse, Saydra Wilson, Thaddeus Walczak, Ziad Nahas","doi":"10.1097/YCT.0000000000001036","DOIUrl":"10.1097/YCT.0000000000001036","url":null,"abstract":"<p><strong>Abstract: </strong>Electroconvulsive therapy (ECT) is an effective and safe treatment for severe major depressive disorder. However, status epilepticus is a rare yet serious complication that can occur following treatment. We present a case of a patient with severe major depression who experienced convulsive status epilepticus during the first treatment of her fourth ECT course. Electroconvulsive therapy treatment was then discontinued, and the patient underwent unsuccessful medication trials. Due to deterioration of depressive symptoms, ECT resumption was considered 3 months later after the patient had been maintained on an antiepileptic drug and no further seizures had occurred. Electroconvulsive therapy was resumed with a detailed safety protocol that included electroencephalographic monitoring before and after ECT treatment, remaining on an antiepileptic drug during the course of treatment, performing ECT in the operating room, and preparing seizure-terminating drugs before each treatment. The patient completed her ECT course with no tardive seizures or other neurological complications. We present the safety measures taken for resumption of ECT in our patient, and we offer preliminary clinical guidelines for resuming ECT after a complication of status epilepticus.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"68-70"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555964","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}