调整脉冲宽度对精神分裂症电休克治疗认知副作用的影响

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition Pub Date : 2025-05-24 DOI:10.1016/j.scog.2025.100369

Qi Si , Yingbo Dong , Yuting Li , Guoxin Xu , Yilin Tang , Peiyu Cao , Congxin Chen , Fangfang Ren , Runda Li , Yuxiu Sui

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引用次数: 0

摘要

大多数研究表明，与短脉冲（BP）电痉挛治疗相比，超短脉冲（UBP）电痉挛治疗（ECT）大大减少了认知障碍，尽管结果仍不确定。方法采用随机、双盲、对照试验设计。共有114名精神分裂症患者（SCZ）被纳入研究，并接受了BP ECT（63名参与者）或UBP ECT（51名参与者）。治疗前后评估认知功能，同时收集外周血生物标志物和海马磁共振波谱（MRS）数据。结果两组患者在人口学和临床特征方面无显著基线差异。电刺激结束后，UBP组和BP组分别在造径测试（TMT）和霍普金斯语言学习测试（HVLT）中表现出优势。其他认知测试组间差异无统计学意义。UBP组大鼠同型半胱氨酸、催乳素、诱导型一氧化氮合酶和左海马肌醇（MI）水平显著高于BP组。多元线性回归分析表明，右侧海马MI水平与TMT评分呈正相关。结论高剂量UBP ECT与BP ECT的疗效无显著差异，该方式是否能减轻治疗后认知功能障碍仍需进一步研究。临床试验注册https://www.chictr.org.cn/showproj.html?proj=243964，注册号：ChiCTR2400091601。

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Effects of modifying the pulse width on cognitive side effects with electroconvulsive therapy for schizophrenia

Background

The majority of studies have shown substantially reduced cognitive impairment with ultra-brief pulse (UBP) electroconvulsive therapy (ECT) compared to brief pulse (BP) ECT, though the results remain inconclusive.

Methods

This study employed a randomized, double-blind, controlled trial design. A total of 114 patients with schizophrenia (SCZ) were enrolled and received BP ECT (63 participants) or UBP ECT (51 participants). Cognitive function was assessed before and after treatment, with peripheral blood biomarkers and hippocampal magnetic resonance spectroscopy (MRS) data collected concurrently.

Results

No significant baseline differences in demographic or clinical characteristics were observed between the two groups. After the end of ECT sessions, the UBP group and BP group respectively showed advantages in the Trail Making Test (TMT) and Hopkins Verbal Learning Test (HVLT). No between-group differences reached statistical significance in other cognitive tests. The homocysteine, prolactin, inducible nitric oxide synthase and left hippocampal myoinositol (MI) levels were significantly elevated in the UBP group than those in the BP group. Multiple linear regression analysis indicated that right hippocampal MI levels were positively correlated with TMT scores.

Conclusion

There are no significant differences in efficacy between UBP ECT at high-dosage and BP ECT, and further research is required to determine whether this modality can reduce cognitive impairment after treatment.