Safety and feasibility of magnetic seizure therapy (MST) in major depression: Randomized within-subject comparison with electroconvulsive therapy
Safety and feasibility of magnetic seizure therapy (MST) in major depression: Randomized within-subject comparison with electroconvulsive therapy
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DOI：
10.1038/sj.npp.1300229
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发表时间：
2003-10-01
影响因子：
7.6
通讯作者：
Sackeim, HA
中科院分区：
文献类型：
--
作者：
Lisanby, SH;Luber, B;Sackeim, HA
磁惊厥治疗（MST）是一种利用快速交变强磁场进行惊厥治疗的新方法。MST比电休克疗法（ECT）更能控制脑内电流强度。这些特征可能导致MST的上级认知副作用特征，同时可能保留ECT的疗效。本研究的目的是确定MST和ECT是否在癫痫发作特征以及急性客观和主观认知副作用方面存在差异。共有10例因重度抑郁发作而转介接受ECT治疗的住院患者入组本随机、受试者内、双盲试验。在一个疗程的前两次惊厥治疗中，采用MST和ECT确定癫痫发作阈值，顺序随机。其余两个会议包括阈上刺激与MST和ECT。在每次治疗前后，由一名设盲的评定者进行神经心理学成套测验和副作用评定量表的评定。所有患者均用MST诱发强直阵挛发作。与ECT相比，MST发作持续时间短，发作期EEG振幅低，发作后抑制少。与ECT相比，MST患者的主观副作用更少，定向力恢复更快。MST在注意力、逆行性遗忘和类别流畅性方面也上级优于ECT。磁诱导癫痫发作在抑郁症患者中是可行的，并且似乎比ECT具有上级急性副作用。未来的研究将需要确定MST是否具有抗抑郁疗效。
Magnetic seizure therapy (MST) is a novel means of performing convulsive therapy using rapidly alternating strong magnetic fields. MST offers greater control of intracerebral current intensity than is possible with electroconvulsive therapy (ECT). These features may result in a superior cognitive side effect profile for MST, while possibly retaining the efficacy of ECT. The objective of this study was to determine whether MST and ECT differ in seizure characteristics, and acute objective and subjective cognitive side effects. A total of 10 inpatients in a major depressive episode referred for ECT were enrolled in this randomized, within-subject, double-masked trial. Seizure threshold was determined with MST and ECT in the first two sessions of a course of convulsive therapy, with order randomized. The remaining two sessions consisted of suprathreshold stimulation with MST and ECT. A neuropsychological battery and side effect rating scale were administered by a masked rater before and after each session. Tonic-clonic seizures were elicited with MST in all patients. Compared to ECT, MST seizures had shorter duration, lower ictal EEG amplitude, and less postictal suppression. Patients had fewer subjective side effects and recovered orientation more quickly with MST than ECT. MST was also superior to ECT on measures of attention, retrograde amnesia, and category fluency. Magnetic seizure induction in patients with depression is feasible, and appears to have a superior acute side effect profile than ECT. Future research will be needed to establish whether MST has antidepressant efficacy.