EFFECTS OF STIMULUS-INTENSITY AND ELECTRODE PLACEMENT ON THE EFFICACY AND COGNITIVE EFFECTS OF ELECTROCONVULSIVE-THERAPY
EFFECTS OF STIMULUS-INTENSITY AND ELECTRODE PLACEMENT ON THE EFFICACY AND COGNITIVE EFFECTS OF ELECTROCONVULSIVE-THERAPY
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DOI：
10.1056/nejm199303253281204
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发表时间：
1993-03-25
影响因子：
158.5
通讯作者：
SETTEMBRINO, JM
中科院分区：
文献类型：
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作者：
SACKEIM, HA;PRUDIC, J;SETTEMBRINO, JM
背景。电惊厥治疗重度抑郁症的疗效已经确定，但电剂量和电极放置对疗效和副作用的影响尚不确定。在一项双盲研究中，我们随机分配96名抑郁症患者接受右单侧或双侧电惊厥治疗，低电剂量（刚好高于癫痫阈值）或高剂量（阈值的2.5倍）。在治疗前、治疗中、治疗后和治疗后两个月分别评估抑郁症状和认知功能。对治疗有反应的患者进行了为期一年的随访，以评估复发率。低剂量单侧电休克治疗的有效率为17%，而高剂量单侧电休克治疗的有效率为43% (P = 0.054)，低剂量双侧电休克治疗的有效率为65% (P = 0.001)，高剂量双侧电休克治疗的有效率为63% （P = 0.001）。无论电极放置方式如何，高剂量改善更快(P
Background. The efficacy of electroconvulsive therapy in major depression is established, but the importance of the electrical dosage and electrode placement in relation to efficacy and side effects is uncertain.Methods. In a double-blind study, we randomly assigned 96 depressed patients to receive right unilateral or bilateral electroconvulsive therapy at either a low electrical dose (just above the seizure threshold) or a high dose (2.5 times the threshold). Symptoms of depression and cognitive functioning were assessed before, during, immediately after, and two months after therapy. Patients who responded to treatment were followed for one year to assess the rate of relapse.Results. The response rate for low-dose unilateral electroconvulsive therapy was 17 percent, as compared with 43 percent for high-dose unilateral therapy (P = 0.054), 65 percent for low-dose bilateral therapy (P = 0.001), and 63 percent for high-dose bilateral therapy (P = 0.001). Regardless of electrode placement, high dosage resulted in more rapid improvement (P