Prediction of antidepressant response in both 2.25 x threshold RUL and fixed high dose RUL ECT
Prediction of antidepressant response in both 2.25 x threshold RUL and fixed high dose RUL ECT
复制标题
DOI：
10.1016/j.jad.2008.03.030
复制
发表时间：
2009-01-01
影响因子：
6.6
通讯作者：
McCall, Vaughn
中科院分区：
文献类型：
--
作者：
Kimball, James N.;Rosenquist, Peter B.;McCall, Vaughn
某些形式的电休克治疗（ECT）可导致缺乏疗效的全身性癫痫发作，因此治疗充分性的生理标志物将是有帮助的。EEG，癫痫发作质量的测量，如EEG规律性和发作后抑制，已经在很大程度上取代了癫痫发作持续时间作为癫痫发作充分性的标志物，但没有预测算法得到广泛的临床接受。在许多情况下，小于25 s的电描记癫痫发作持续时间仍提示再次刺激。我们重新检查的实用程序的EEG癫痫发作持续时间和其他措施的EEG癫痫发作作为预测抗抑郁药反应的右侧单侧（RUL）ECT.Methods：72例成人抑郁症患者被随机分配到滴定RUL ECT在2.25倍初始癫痫发作阈值或RUL ECT在固定剂量为403 mC。意向治疗应答者状态（定义为HRSD评分降低60%，最后一次RUL ECT治疗后最终评分为12或更低）被确定为名义逻辑回归模型中的因变量，包括EEG癫痫发作质量候选变量，控制年龄和性别。模型包括EEG发作持续时间、EEG规律性、发作后抑制，年龄、性别和随机化状态是治疗2时意向治疗应答者状态的显著预测因素（R2=.21 p
Some forms of electroconvulsive therapy (ECT) can result in generalized seizures that lack efficacy, therefore physiological markers of treatment adequacy Would be helpful. EEC, measures of seizure quality, Such as EEG regularity and post-ictal suppression, have largely supplanted seizure duration as a marker for seizure adequacy, yet no predictive algorithm has gained wide clinical acceptance. Electrographic seizure durations of less than 25 s still prompt re-stimulation in many settings. We re-examined the utility of EEG seizure duration and other measures of EEG seizure as predictors of antidepressant response to right unilateral (RUL) ECT.Methods: Seventy-two adult patients with major depression were randomized to either titrated RUL ECT at 2.25 times initial seizure threshold or RUL ECT at a fixed dose of 403 mC. Intent-to-treat responder status (defined by 60% reduction in HRSD scores and final score of 12 or less after the last RUL ECT session) was identified as the dependent variable in a nominal logistic regression model including EEG seizure quality candidate variables, controlled for age and gender.Results: A model including EEG seizure duration, EEG regularity, post-ictal suppression, age and gender and randomization status was significantly predictive of intent-to-treat responder status at treatment 2 (R2=.21 p