Journal of Ect最新文献

{"title":"Recurrent Depression With Catatonic Excitement in a Patient With Moyamoya Disease: A Case Report.","authors":"In Won Chung, Heung Sik Kim, Yu Jin Lee, Jung Bin Km, Gyu Man Han, Sang Ha Kim, Yong Sik Kim","doi":"10.1097/YCT.0000000000001218","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001218","url":null,"abstract":"<p><p>We report the case of a 76‑year‑old woman with a 25‑year history of neuropsychiatric symptoms and Moyamoya vasculopathy, first identified in 2016. She presented in March 2025 with severe catatonic excitement and began electroconvulsive therapy (ECT) starting in April, showing marked clinical improvement within 3 sessions. Genetic testing confirmed moyamoya disease (MMD) with a pathogenic RNF213 mutation, associated with increased risk of infarction or hemorrhage. After trials with several anesthetic agents, dexmedetomidine (DEX) combined with remifentanil was selected, enabling stable anesthesia with a consistent electrical dose of 192 mC across 35 sessions over 5 months. The main challenges included hemodynamic stability in MMD, prevention of post‑ictal agitation in advanced age and catatonia, and preservation of seizure quality despite repeated ECT. This case highlights the safe and effective use of ECT with DEX and remifentanil in a patient with genetically confirmed MMD with catatonic symptoms.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783431","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":"Dexmedetomidine and Nitrous Oxide as Anesthetic Agents for Electroconvulsive Therapy: A Case Report.","authors":"In Won Chung, Heung Sik Kim, Junhee Lee, Jee Hee Kim, Sang Ha Kim, Yong Sik Kim","doi":"10.1097/YCT.0000000000001096","DOIUrl":"10.1097/YCT.0000000000001096","url":null,"abstract":"<p><strong>Abstract: </strong>Electroconvulsive therapy (ECT) is a therapeutic intervention that induces generalized seizures under general anesthesia. This case report compares the efficacy of dexmedetomidine (DEX) and nitrous oxide (N 2 O) to that of propofol during ECT procedures. A 33-year-old woman with a 15-year history of schizophrenia and recurrent psychotic episodes underwent ECT. During a previous hospitalization, she underwent 14 ECT sessions using propofol and succinylcholine. The mean electrical stimulation dose was 598.9 ± 237.6 mC, with mean motor and electroencephalogram seizure durations of 23.8 ± 8.0 and 34.9 ± 8.3  seconds, respectively. During her current hospitalization, she underwent an additional 14 ECT sessions using DEX and N 2 O. The mean electrical stimulation dose was significantly lower, at 239.4 ± 54.7 mC, with comparable motor and electroencephalogram seizure durations of 34.6 ± 11.6 and 36.3 ± 12.5  seconds, respectively. Our case report emphasizes the effectiveness of using DEX and N 2 O for ECT anesthesia compared to propofol. Despite a significantly lower mean electrical stimulation dose requirement with DEX and N 2 O (t = 5.5155, P  < 0.00001), no significant differences were observed in electroencephalogram seizure duration between the groups.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"286-288"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803505","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":"Optimizing Electroconvulsive Therapy With E-Field Modeling: A Narrative Review.","authors":"Caili Ren, Simon Kung, Paul E Croarkin, Alexander Opitz, Brent P Forester, Adriana P Hermida, Martina Mueller, Sandeep R Pagali, Georgios Petrides, Stephen J Seiner, Isabel A Yoon, Maria I Lapid","doi":"10.1097/YCT.0000000000001111","DOIUrl":"10.1097/YCT.0000000000001111","url":null,"abstract":"<p><strong>Abstract: </strong>Electroconvulsive therapy (ECT) is an effective treatment for severe depression, especially in treatment-resistant cases. However, its potential cognitive side effects necessitate careful dosing to balance therapeutic benefits and cognitive stability. Recent advances in electric field (E-field) modeling offer promising avenues to optimize ECT dosing. This review synthesizes current knowledge on E-field modeling in ECT and explores its clinical applications. It examines the variability in E-field strengths and distributions induced by ECT and their impact on clinical outcomes. Additionally, the relationship between E-field strengths, neuroplasticity, and therapeutic efficacy is discussed. Translational studies of E-field-informed ECT are highlighted, emphasizing individualized optimal amplitude dosing and potential clinical applications. This review provides useful insights into how E-field modeling can improve the effectiveness of ECT while minimizing adverse effects, helping guide future research and clinical practice.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"281-285"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034843","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":"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":"257-267"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","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":"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":"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 (HDRS 17 ), 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":"238-243"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","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":"Electroconvulsive Therapy for Catatonia in a Patient With Schizophrenia Comorbid With Becker Muscular Dystrophy: A Case Report.","authors":"Shun Igarashi, Hitomi Hashimoto, Tomoyuki Miyazaki, Hotake Takizawa, Daisuke Hayashi, Kentaro Nagao, Koichiro Kumagai, Koichiro Watanabe, Takamasa Noda, Shinsuke Kito","doi":"10.1097/YCT.0000000000001149","DOIUrl":"10.1097/YCT.0000000000001149","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"e60-e61"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058369","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 Retrospective Analysis of the Impact of Electroconvulsive Therapy on Anxiety Symptoms in Patients With Treatment-Resistant Depression.","authors":"Julia Laszcz, Chenyang Wang, Patricio Riva-Posse, Jonathan Kim, Valeriya Tsygankova, Ally Mandell, Hanna Rice, Adriana Hermida, Brandon M Kitay, Andrea Crowell, William M McDonald, Rachel Hershenberg","doi":"10.1097/YCT.0000000000001113","DOIUrl":"10.1097/YCT.0000000000001113","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Electroconvulsive therapy (ECT) is an effective treatment for treatment-resistant depression (TRD). There are limited data on the improvement of anxiety symptoms in patients receiving ECT for TRD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of the study was to examine the extent to which anxiety symptom severity improves, relative to improvements in depressive symptoms, in TRD patients receiving an acute course of ECT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective chart review of 117 TRD patients who received an acute ECT course in a naturalistic outpatient setting was conducted. Symptomatic response was measured using the Beck Depression Inventory II and Generalized Anxiety Disorder 7 Scale. Two generalized estimating equation models assessed the degree of change in anxious symptoms relative to the change in depressive symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Both depression (-0.09, P  &lt; 0.001) and anxiety (-0.08, P  &lt; 0.001) improved after ECT treatment, with a greater standardized decrease for symptoms of depression. Higher levels of anxiety over the treatment (-0.42, P  &lt; 0.001) were associated with smaller antidepressant improvements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;ECT may improve symptoms of anxiety in patients with TRD. Anxiety symptoms show a favorable trajectory of improvement, though to a lesser extent, relative to changes in symptoms of depression. Higher symptoms of anxiety throughout the treatment course may be a negative predictor of antidepressant response in ECT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Highlights: &lt;/strong&gt;-Patients with treatment-resistant depression (TRD) referred for ECT may experience anxiety.- Little is known about anxiety symptom changes during an ECT course.- Retrospective data was analyzed for 117 TRD patients during an acute ECT course.- Anxiety symptoms improved but not as robustly as depressive symptoms.- More anxiety during treatment predicted worse antidepressant outcomes.Major depressive disorder (MDD) is one of the most common psychiatric disorders in both specialist and general medical practice. 1 Symptoms of depression and anxiety are likely to co-occur, with 40%-60% of MDD patients experiencing anxiety symptoms. 2,3 Importantly, the presence of co-occurring anxiety is a negative prognostic factor. Indeed, the co-occurrence of anxiety symptoms or disorders has significant implications for MDD disease course and burden. For example, when anxiety is comorbid with MDD, the progression of the disease is more refractory to standard antidepressant treatment. 4,5 Coexisting anxiety symptoms make treating MDD more difficult than MDD without anxiety symptoms, 6 and individuals with depression and co-morbid anxiety disorders or symptoms are at greater risk of suicide. 7 Consistent with this, anxiety symptoms in patients with MDD are associated with increased use of healthcare resources. 8 Residual anxiety symptoms following improvements in depressive symptoms place patients at greater risk for r","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"250-256"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034825","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":"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":"e53-e54"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","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":"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":"244-249"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","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":"Letter to the Editor: Recurring Use of Sugammadex for the Reversal of Rocuronium-Induced Neuromuscular Blockade in ECT.","authors":"Tanmai Bandarupalli, Larry H Kuhn","doi":"10.1097/YCT.0000000000001137","DOIUrl":"10.1097/YCT.0000000000001137","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":"e59-e60"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631082","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}