Journal of Ect最新文献

{"title":"Adjunctive High-Definition Transcranial Direct Current Stimulation in Treatment of Resistant Auditory Verbal Hallucinations in Schizophrenia: A Randomized Sham-Controlled Trial.","authors":"Apurba Narayan Mahato, Sanjay Kumar Munda, Alok Pratap, Satyanarayanprabhu Mudaliyar, Natasha Patel","doi":"10.1097/YCT.0000000000001109","DOIUrl":"10.1097/YCT.0000000000001109","url":null,"abstract":"<p><strong>Background: </strong>Resistant auditory verbal hallucination (AVH) remains a disabling symptom in schizophrenia. Transcranial direct current stimulation (tDCS) and its more targeted variant, high-definition tDCS (HD-tDCS), have shown promising results in reducing AVH. We aimed to determine the effects of adjunctive HD-tDCS on various dimensions of AVH in patients with schizophrenia.</p><p><strong>Methodology: </strong>This randomized controlled trial included 40 patients with schizophrenia with resistant AVH (20 patients each assigned to the active and sham group). A stimulation electrode was placed over the left temporoparietal junction at CP5 according to the 10-10 EEG montage, while return electrodes were positioned at C3, T7, P3, and P7. The active group received 2-mA current for 20 minutes, with a ramp-up and ramp-down of 3 seconds, whereas the sham group received 1-mA current for 30 seconds, with a 3-second ramp-up and ramp-down. AVH severity was assessed using the Psychotic Symptom Rating Scale-Auditory Hallucination at baseline, at the end of HD-tDCS sessions, and 4 weeks after completion.</p><p><strong>Results: </strong>Within-group comparisons revealed significant improvements in both groups. However, in time*group comparison, the group receiving active HD-tDCS showed a statistically significant improvement only in the frequency dimension of AVH over time ( p = 0.011). No other dimensions of AVH improved significantly in the time*group comparison. The effects of HD-tDCS were sustained up to 4 weeks.</p><p><strong>Conclusions: </strong>Active HD-tDCS over the left temporoparietal junction significantly reduced the frequency of AVH in patients with schizophrenia compared to sham stimulation. However, no significant improvements were observed in other domains of hallucination.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034827","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":"Changes in Cerebral Hemodynamic Among Patients With Schizophrenia or Bipolar Disorder Receiving Electroconvulsive Therapy: A Task-Related Functional Near-Infrared Spectroscopy Study.","authors":"Keng-Hong Chhoa, Soon-Kiat Chiang, Kheng-Yee Ong, Choon-Keat Yong, Bee-Zhen Ng, Siti-Zubaidah Othman, Roger S McIntyre, Jongkwan Choi, Jihyun Cha, Roger C Ho, Kok-Yoon Chee","doi":"10.1097/YCT.0000000000001110","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001110","url":null,"abstract":"<p><strong>Abstract: </strong>There remains a scarcity of studies to evaluate the treatment effect of electroconvulsive therapy (ECT). Functional near-infrared spectroscopy (fNIRS) offers a cost-effective method to measure cerebral hemodynamics. This study used fNIRS to evaluate the effect of ECT in patients suffering from schizophrenia or bipolar disorder (manic phase). Thirty patients with mania and 31 with schizophrenia were recruited. Each participant received 6 sessions of ECT. This study utilized the Positive and Negative Syndrome Scale, Young Mania Rating Scale, and fNIRS-verbal fluency test paradigm at baseline and after each session of ECT. The prefrontal cortex hemodynamic response during the performance of verbal fluency test was recorded via a commercial wireless high-density continuous-wave fNIRS system device. The effect of categorical and continuous variables was determined using Pearson's chi-square test and Student's t test or 1-way analysis of variance with Bonferroni-corrected post hoc pairwise comparison, respectively. Comparing the Positive and Negative Syndrome Scale and Young Mania Rating Scale scores between baseline, sessions 3 and 6, the scores were significantly decreased (P < 0.001), with both patient groups achieving more than 50% reduction in scores from baseline to session 6. The fNIRS also showed significant increases in oxy-hemoglobin levels (session 6 vs baseline) in the right ventrolateral prefrontal cortex and left dorsolateral prefrontal cortex for both patient groups (P < 0.05). There were significant correlations in the reduction of symptom severity and increase in HbO2 levels in people with bipolar disorder (manic phase) and schizophrenia (P < 0.05). Monitoring the activation in the right ventrolateral prefrontal cortex and left dorsolateral prefrontal cortex is an objective ECT monitoring indicator for patients suffering from bipolar disorder (manic phase) or schizophrenia.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034829","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":"Improvement in Quality of Seizures in Electroconvulsive Therapy With Zotepine: A Case Report.","authors":"Teruyuki Matsuoka, Nobutaka Ayani, Sumihiro Yamano","doi":"10.1097/YCT.0000000000001112","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001112","url":null,"abstract":"<p><strong>Abstract: </strong>Regular symmetric high-amplitude seizure waves, postictal suppression, constant seizure duration, and sympathetic nervous system excitation are used to evaluate the efficacy of electroconvulsive therapy (ECT) for seizures. Seizure quality is rated from 0 to 3 (higher scores indicate better quality) using seizure quality categories (SQC). We report a case in which zotepine (ZTP) improved seizure quality. A woman in her 50s developed schizophrenia in 1993. In December 2021, her delusions, anxiety, and agitation worsened, and she was admitted to our hospital. ECT was started in November 2022 but discontinued after 10 sessions because of the patient's refusal. However, her agitation became more noticeable, and she was placed in isolation in December 2022. ECT was resumed in March 2023 and accompanied by risperidone (RIS) 4 mg, with SQC scores of 1-2 points for sessions 1-8. A gradual change from RIS to ZTP began at session 9, and RIS was discontinued by session 17. The SQC was 2 points with ZTP dose of 150 mg. The SQC improved to 3 points during sessions 21-23 after ZTP dose was increased to 300 mg. The electroencephalogram showed improvement, especially in regular symmetric high-amplitude seizure waves and postictal suppression during sessions 21-23. ECT was terminated in September 2023 (after 27 sessions in total) when the patient was mentally ready to be released from isolation. This case indicates that ZTP may improve the quality of ECT-induced seizures.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124134","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":"Oral Esketamine as Alternative for Maintenance Electroconvulsive Therapy in Patients With Treatment-Resistant Depression: A Case Series.","authors":"Daniël T Coerts, Jolien K E Veraart, Jeanine Kamphuis, Sanne Y Smith-Apeldoorn, Robert A Schoevers, Sjoerd M van Belkum","doi":"10.1097/YCT.0000000000001103","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001103","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigates repeated oral esketamine as a substitution strategy for maintenance electroconvulsive therapy (M-ECT) in eight patients with treatment-resistant depression (TRD).</p><p><strong>Methods: </strong>In a 6-week dosing phase, esketamine was titrated from 0.5 or 1.0 mg/kg to a maximum of 3.0 mg/kg twice weekly. Outcomes included 6-week change in Inventory of Depressive Symptomatology - Self-rated (IDS-SR), Hamilton Depression Rating Scale - 17 items (HDRS17), and Outcome Questionnaire 45 (OQ-45), along with esketamine treatmentcontinuation.</p><p><strong>Results: </strong>Depression severity remained stable or improved in five patients, whereas three experienced worsening symptoms and resumed M-ECT. OQ-45 scores were available for five patients, all of whom showed improvement. Currently, four patients are still receiving oral esketamine.</p><p><strong>Conclusions: </strong>Repeated oral esketamine may be a suitable and patient-friendly alternative to M-ECT. We recommend controlled trials to compare long-term safety and efficacy.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034846","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":"A Case of Asymmetric Seizure Termination During an Acute Course of Right Unilateral Electroconvulsive Therapy.","authors":"Brandon C Salzman, Mikhail Heber, Stephen Ferber","doi":"10.1097/YCT.0000000000001104","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001104","url":null,"abstract":"<p><strong>Abstract: </strong>Electroencephalogram (EEG) monitoring during electroconvulsive therapy (ECT) is commonly done using a 2-channel EEG in order to capture activity from both brain hemispheres, though many institutions may instead opt to utilize a 1-channel EEG, often for reasons of convenience. We present a novel case of asymmetric termination of EEG seizure activity during an acute course of right unilateral ECT, prompting a full neurological workup to investigate potential underlying structural or physiological causative factors. This case assists in informing the necessity of bilateral hemispheric EEG monitoring as well as highlights the importance of searching for undiagnosed or latent neurological dysfunction in certain clinical situations arising during ECT.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962573","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 and Clozapine Augmentation in an Older Adult With Bipolar Disorder With Psychotic Features: Case Report.","authors":"Natalie Lomayesva, Ethan Solomon, Chanae Hardamon, Lucy Lan, Parnika Saxena","doi":"10.1097/YCT.0000000000001105","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001105","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962576","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":"Letter to the Editor: ECT and Forensic Psychiatry.","authors":"Ana S Iltis, Brian J Basden, William V McCall, Peter B Rosenquist, Sandarsh Surya","doi":"10.1097/YCT.0000000000001102","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001102","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962580","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":"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":"https://doi.org/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":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-07","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":"Autoimmune Encephalitis in Catatonic and Treatment-Resistant Psychotic Patients Referred to Electroconvulsive Therapy: Two Case Reports and Systematic Review.","authors":"Maria Francesca Beatino, Francesco Weiss, Samuele Torrigiani, Valerio Caruso, Camilla Elefante, Pierpaolo Medda, Giulio Emilio Brancati, Giulio Perugi","doi":"10.1097/YCT.0000000000001092","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001092","url":null,"abstract":"<p><strong>Abstract: </strong>Autoimmune encephalitis (AE) tends to manifest as a mixture of neuropsychiatric and somatic symptoms, either of which may predominate, and often shows a progressive clinical course sometimes leading to life-threatening conditions. Catatonic and psychotic syndromes, regardless of whether associated with dysautonomia, are common manifestations of AE, especially concerning the anti-NMDAR subtype. Several autoantibodies targeting different neuronal epitopes have been linked to specific clinical manifestations and their detection is embedded in some of the diagnostic criteria for AE. Therapeutical management of AE is challenged by limited diagnostic abilities and poor understanding of the underlying pathophysiology for most of its subtypes. Although the prompt delivery of disease-modifying therapies represents the cornerstone of treatment and primarily affects prognosis, less is known about the role of symptom specific supportive measures like electroconvulsive therapy (ECT). Based on a systematic review of 26 patient-level descriptions of individuals, each with a diagnosis of AE treated with ECT, a favorable clinical response was found in more than ¾ of the revised cases (76.9%). The most common indications for ECT administration were catatonic and psychotic syndromes, often nonresponsive to prior pharmacotherapy with benzodiazepines, antipsychotic, and other psychotropic drugs. Noteworthy side effects were only reported for 3 of 26 patients. Though the low number of cases and publication bias should be considered as major limitations, current available reports are in support of the inclusion of ECT in the integrated therapeutic algorithm of AE to address psychiatric conditions such as severe psychosis and catatonia.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962566","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 Treatment in Adolescents in Singapore.","authors":"Birong Chen, Yuqian Fu, Ziqiang Li, Xiaowei Tan, Juanjuan Li, Manoza Michaela Herrera, Doris Sok Hian Koh, Phern Chern Tor","doi":"10.1097/YCT.0000000000001101","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001101","url":null,"abstract":"<p><strong>Background: </strong>Electroconvulsive therapy (ECT) is a highly effective treatment for schizophrenia and mood disorders; however, most evidence is derived from the adult population, with less evidence in adolescents. We sought to determine the use of ECT in adolescents in the Institute of Mental Health (IMH) and evaluate the treatment outcome.</p><p><strong>Methods: </strong>We conducted a retrospective naturalistic analysis of ECT registry data of patients aged from 10 to 19 years from March 2017 to March 2023. Descriptive analysis was used to analyze the demographics and clinical characteristics. Paired t tests were used to compare the change in clinical outcome scores, including the Brief Psychiatric Rating Scale (BPRS), Montgomery-Asberg Depression Rating Scale (MADRS), Clinical Global Impressions Scale - Severity (CGI-S), and Montreal Cognitive Assessment (MoCA) before and after 2 weeks of ECT treatment.</p><p><strong>Results: </strong>Fifty-five patients were included for analysis. There was a significant improvement in BPRS (P < 0.001), MADRS (P = 0.005), and CGI-S (P < 0.001), and the average CGI-I score was 2.275 (SD, 0.81), which is equivalent to \"much improved\" after 6 sessions of treatment. Of all patients, 48.5% showed significant clinical improvement. There was no significant change in MoCA scores (P = 0.218).</p><p><strong>Conclusions: </strong>Our preliminary findings show that ECT is a safe, rapid, and effective treatment for psychotic and mood disorders in adolescents. Further studies with a larger sample size and specific subgroup analysis are needed to establish the effectiveness of ECT and identify predictors of response in this population.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962570","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}