Journal of Ect最新文献

{"title":"Probable Seizure During High-Frequency Ipsilesional Motor Cortex Repetitive Transcranial Magnetic Stimulation for Poststroke Upper-Limb Weakness: A Case Report.","authors":"Dhruv Khanna, Randeep Singh, Shobit Garg, Arti Rawat","doi":"10.1097/YCT.0000000000001323","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001323","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978699","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":"Two-Year Clinical Outcomes of Vagus Nerve Stimulation for Higher-Grade Treatment-Resistant Depression: A Prospective Open-Label Multicenter Cohort Study.","authors":"Kfir Feffer, Ido Straus, Zeev Feldman, Aviv Solomon, Esther Bloemhof-Bris, Rachel Nega, Gilad Gal, Aviad Hadar, Yoav Domany","doi":"10.1097/YCT.0000000000001319","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001319","url":null,"abstract":"<p><strong>Objectives: </strong>To assess 24-month clinical outcomes of vagus nerve stimulation (VNS) in individuals with higher-grade treatment-resistant depression (HG-TRD) treated within a national open-label program, focusing on depressive severity, suicidality, safety, tolerability, and rates of response and remission.</p><p><strong>Methods: </strong>A prospective, open-label, multicenter cohort study was conducted on 19 patients who underwent VNS implantation between 2020 and 2023. Clinical assessments were performed at baseline and at 6, 12, 18, and 24 months. Depressive symptoms were evaluated using the Montgomery-Åsberg Depression Rating Scale (MADRS), including item 10 for suicidality. Outcomes included mean percentage change in MADRS scores, rates of response, remission, partial response, adverse events, and adherence. Sixteen participants completed the 24-month follow-up. All analyses were exploratory.</p><p><strong>Results: </strong>MADRS scores decreased significantly by 6 months (P<0.001) and remained improved throughout follow-up, with a mean reduction of 48% in 24 months. Cumulatively, 87.5% of participants experienced a clinically defined response during the 24-month period. Suicidality (MADRS item-10 scores) decreased significantly (P<0.001) and this improvement persisted throughout follow-up. No serious safety concerns were identified. Tolerability and long-term adherence were high, with most patients continuing active device use throughout the study period.</p><p><strong>Conclusions: </strong>In this open-label, multicenter cohort of individuals with HG-TRD, VNS was associated with substantial and durable reductions in depressive severity and suicidality over 24 months. Despite limitations related to sample size and lack of a control group, the magnitude and persistence of clinical benefit support VNS as a viable long-term treatment for carefully selected patients with severe, highly resistant depression.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978659","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 Seronegative Paraneoplastic Encephalitis With Catatonia: Case Report.","authors":"Carolina Sequeira, Maria João Brito, José Diogo Andrade, Manuel Canelas Pais, Susana Renca","doi":"10.1097/YCT.0000000000001325","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001325","url":null,"abstract":"<p><p>Autoimmune encephalitis frequently presents with prominent psychiatric symptoms and may mimic primary psychiatric disorders, particularly in the early stages. We report the case of a 38-year-old man who presented with a 2-week history of behavioral disturbance, persecutory ideation, auditory hallucinations, and fluctuating disorganization of thought and behavior, without prior psychiatric history. During hospitalization, the clinical picture evolved to include psychomotor retardation and prominent catatonic features. Given the subacute onset and atypical presentation, autoimmune encephalitis was suspected. Cancer screening identified a mixed testicular germ cell tumor, and right orchiectomy was performed. Despite tumor removal and immunotherapy, the patient showed no meaningful clinical improvement and progressed to severe catatonia. Pharmacological treatment with benzodiazepines and antipsychotic medications was ineffective. Electroconvulsive therapy was therefore initiated. After 12 bitemporal electroconvulsive therapy sessions, a marked and sustained clinical improvement was observed, with progressive resolution of catatonic, psychotic, and behavioral symptoms. This case highlights that severe catatonia may represent the dominant psychiatric manifestation of seronegative paraneoplastic encephalitis and suggests that electroconvulsive therapy may be an effective therapeutic option for refractory catatonia in this context.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978730","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":"Altered Cerebral Perfusion and the Emergence of Schneiderian First-Rank Symptoms Following Modified Electroconvulsive Therapy in Late-Life Depression: A Case Report.","authors":"Teruomi Iyo, Yasunori Oda, Yuki Ikemizu, Koichi Matsuyama, Kiwamu Hoshi, Takeru Saito, Kazuki Okada, Tsuyoshi Sasaki, Tomihisa Niitsu, Masaomi Iyo","doi":"10.1097/YCT.0000000000001328","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001328","url":null,"abstract":"<p><p>Electroconvulsive therapy (ECT) is a well-established treatment for severe or treatment-resistant major depressive disorder and schizophrenia, often leading to rapid symptom improvement. However, ECT can rarely cause adverse psychological effects, including new-onset auditory hallucinations. We present the case of a 71-year-old woman with major depressive disorder who showed rapid clinical improvement following ECT, along with restoration of cerebral blood flow in the frontotemporal and parietal regions as shown by neuroimaging. Despite remission of depressive symptoms, she developed de novo auditory hallucinations with a running commentary, classified as Schneiderian first-rank symptoms, which persisted for several months despite continued treatment with olanzapine. Unlike previously reported cases in which hallucinations resolved shortly after completion of ECT, this case highlights a rare instance of persistent hallucinations that emerged during the same period as cerebral perfusion changes but cannot be interpreted as causally or associatively related based on the available data. Although perfusion improvement was observed, these imaging findings should be regarded solely as descriptive observations rather than indicators of a mechanistic link. To our knowledge, this is the first report to describe the coexistence of ECT-induced cerebral blood flow changes and new-onset auditory hallucinations; however, no meaningful clinical-biological connection can be inferred from this single case. This finding underscores the need for further investigation into the neurobiological mechanisms underlying rare ECT-related side effects to improve patient management and safety.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978663","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":"Accelerated Transcranial Magnetic Stimulation Is Safe and Effective in a Case of Peripartum Depression Complicated by Placenta Previa.","authors":"Zachary F Stielper, Jackson R Mierl, B Lochlann McGee","doi":"10.1097/YCT.0000000000001326","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001326","url":null,"abstract":"<p><p>Peripartum depression is a significant cause of maternal and neonatal morbidity and mortality. Electroconvulsive therapy (ECT) is often used in the treatment of severe peripartum depression, but its use may increase the risks of obstetric complications. Accelerated transcranial magnetic stimulation (TMS) protocols, such as the Stanford Accelerated Intelligent Neuromodulation Therapy (SNT), may confer efficacy that rivals ECT with less potential risks. Here, we present a case of severe, treatment-resistant depression in a 38-year-old pregnant female. The patient was referred for ECT; however, she was subsequently diagnosed with placenta previa. To minimize potential complications, the patient was instead treated with SNT TMS. The patient demonstrated a robust response, resulting in remission of her depressive symptoms. The treatment was administered at eighteen weeks' gestation and did not cause any obstetric complications. Accelerated TMS may represent a viable treatment strategy for peripartum depression in patients vulnerable to the increased risks associated with ECT.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978611","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":"Prolonged Post-Electroconvulsive Therapy Delirium in Treatment-Resistant Depression With Central Nervous System Risk Factors Under Programmed Cell Death Protein 1 Inhibitor Therapy: A Case Report.","authors":"Emilia J Berthold, Meltem Baskonus, Joan Koti, Özgün Isik, Katharina Prietzel, Felix Brandl, Josef Priller, Ulrike Vogelmann","doi":"10.1097/YCT.0000000000001324","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001324","url":null,"abstract":"<p><p>We report a diagnostically challenging case of treatment-resistant depression (TRD) in a 52-year-old woman with multiple factors potentially increasing susceptibility to central nervous system (CNS) adverse effects, including global cortical atrophy, concomitant lithium and antipsychotic treatment, and ongoing programmed cell death protein 1 (PD-1) inhibitor therapy. After failing multiple pharmacological and neuromodulatory treatments, electroconvulsive therapy (ECT) was initiated. While ECT led to marked clinical improvement, the patient developed a prolonged delirium after the 12th session, lasting 7 to 10 days, initially raising concern for autoimmune encephalitis under immunotherapy. A comprehensive diagnostic work-up including electroencephalography (EEG), contrast-enhanced magnetic resonance imaging (MRI), and lumbar puncture (LP) found no evidence of nonconvulsive status epilepticus (NCSE), acute structural pathology, or florid autoimmune encephalitis, despite borderline SOX1 antibody reactivity in CSF. Cognition returned to baseline without specific therapy, and follow-up paired serum/CSF testing was negative for SOX1 antibodies. The episode was considered a multifactorial delirium, with ECT as one likely contributing factor alongside concomitant medication, structural brain changes, and PD-1 inhibitor therapy. Following relapse, maintenance ECT was resumed using a modified protocol without recurrence of prolonged delirium. This case highlights that ECT may remain an option in carefully selected complex patients when accompanied by structured diagnostic work-up and interdisciplinary monitoring.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978697","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 Emphasizing Relapse Prevention in Parkinsonian Syndromes With Psychiatric Comorbidities.","authors":"Tenzing D Sherpa, Tathagata Biswas, Vishwa Thakkar, Archana Mishra, Biswa R Mishra","doi":"10.1097/YCT.0000000000001318","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001318","url":null,"abstract":"<p><p>Parkinsonian syndromes with comorbid psychiatric illness present a therapeutic paradox wherein antipsychotics may worsen motor symptoms while dopaminergic agents may exacerbate psychosis. Maintenance electroconvulsive therapy (mECT) has emerged as a critical relapse-prevention strategy, reducing 6-month relapse risk by 43% compared to pharmacotherapy alone. We present 2 cases demonstrating mECT efficacy in sustaining both psychiatric and motor improvements. First, a 70-year-old woman with Parkinson's disease and treatment-resistant schizophrenia improved after acute ECT; motor symptoms relapsed 2 months post-discontinuation but recovered with mECT, allowing medication de-escalation without cognitive decline. Next, a 47-year-old man with multiple system atrophy and severe depression with psychosis showed marked improvement after acute ECT; motor relapse at 1 month was prevented by mECT. Both cases demonstrate that motor improvement cannot be sustained without continued ECT intervention. mECT represents an underutilized strategy deserving wider adoption in neurodegenerative-psychiatric comorbidity, warranting larger prospective trials to establish standardized protocols.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978679","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 Use of High-dose Diazepam in Combination With ECT for Treatment of Pediatric Catatonia.","authors":"Ellen Meierer, Matthew Nilsson, Roslyn Gerwin","doi":"10.1097/YCT.0000000000001316","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001316","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002985","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":"Association of Pre-ECT Anxiety Symptoms With Electroconvulsive Therapy Treatment Efficacy in Schizophrenia: A Retrospective Observational Cohort Study.","authors":"Birong Chen, Hasvinjit Kaur D/O Gulwant Singh, Nisha Chandwani, Jonathan Jie Lee, Shih Ee Goh, Xiao Wei Tan","doi":"10.1097/YCT.0000000000001315","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001315","url":null,"abstract":"<p><strong>Objectives: </strong>Pre-ECT anxiety symptoms are common among patients undergoing Electroconvulsive Therapy (ECT). In this retrospective observational cohort study, we aim to explore the association between pre-ECT anxiety symptoms and ECT treatment outcomes in patients with schizophrenia.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 979 patients with schizophrenia or schizoaffective disorder who received ECT at a tertiary public psychiatric hospital in Singapore. Patients were categorized into two groups based on the mean value of pre-ECT Brief Psychiatric Rating Scale (BPRS) anxiety subdomain score: with anxiety (>6) and without anxiety (≤6). Changes in clinical outcomes were measured using BPRS-psychotic, BPRS-anxiety, BPRS-negative and BPRS-manic subscale, Global Assessment of Functioning, Clinical Global Impression-improvement (CGI-I), EuroQoL-5 Dimension Visual Analogue Scale (EQ-5D-VAS) and Montreal Cognitive Assessment (MoCA) scale. Associations between the pre-ECT anxiety scores and patient sociodemographic, psychiatric symptom subscales, and functional assessments were analyzed.</p><p><strong>Results: </strong>Younger age, a history of ECT, and concurrent antidepressant use were significantly associated with pre-ECT anxiety symptoms. Higher pre-ECT anxiety scores were positively correlated with psychotic, negative, and manic symptom severity, and were negatively correlated with general functioning and subjective quality of life (EQ-5D-VAS) (P<0.001). Pre-ECT anxiety was significantly negatively associated with ECT treatment efficacy measured using CGI-I (adjusted β=-0.11, P=0.03; η²=0.01).</p><p><strong>Conclusion: </strong>Our preliminary findings highlight the importance of assessing anxiety symptoms before ECT. Future prospective studies using validated anxiety-specific instruments are needed to further examine and confirm the association between pre-ECT anxiety symptoms and ECT treatment outcomes.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876843","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":"Implementing Electroconvulsive Therapy for Patients Experiencing Behavioral and Psychological Symptoms of Dementia: A Systematic Review.","authors":"Aditya Nidumolu, Daniel Kapustin, Tarek Benzouak, Sanjay Rao, Sameh Hassan, Shabbir Amanullah","doi":"10.1097/YCT.0000000000001125","DOIUrl":"10.1097/YCT.0000000000001125","url":null,"abstract":"<p><strong>Objectives: </strong>Electroconvulsive therapy (ECT) has long been used to treat behavioral and psychological symptoms of dementia (BPSD). However, there are no guidelines for the use of ECT in this population. Contributing to efforts addressing this gap in the literature, this qualitative systematic review examines areas of consensus and disagreement in currently published protocols for the use of ECT in BPSD.</p><p><strong>Methods: </strong>MEDLINE and PsychInfo were searched for primary and secondary literature meeting the aim of this review. All articles were screened, full-text reviewed, and extracted in duplicate. A framework synthesis methodology was used to identify key steps in conducting ECT for BPSD.</p><p><strong>Results: </strong>Thirty-two studies were included in this systematic review. Although these studies converged on similar indications for using ECT in BPSD, there was significant heterogeneity in the stimulus characteristics used and approaches to maintenance treatment.</p><p><strong>Conclusions: </strong>ECT holds promise in the treatment of BPSD. Although further research is needed to establish optimal treatment parameters, this review can be used by clinicians to identify potential approaches to using ECT.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"143-148"},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652026","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}