Electroconvulsive Therapy Pulse Amplitude and Clinical Outcomes.
Electroconvulsive Therapy Pulse Amplitude and Clinical Outcomes.
复制标题
电击疗法脉搏振幅和临床结果。
DOI：
10.1016/j.jagp.2020.06.008
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
McClintock SM
中科院分区：
文献类型：
--
作者：
Abbott CC;Quinn D;Miller J;Ye E;Iqbal S;Lloyd M;Jones TR;Upston J;Deng Z;Erhardt E;McClintock SM
电休克治疗（ECT）脉冲幅度决定了大脑中的感应电场大小，目前在现代ECT设备上设置为800-900毫安（mA），没有任何临床或科学依据。本研究评估了急性ECT系列中三种不同脉冲幅度的抑郁和认知结果的差异。我们假设，较低的振幅将保持标准治疗的抗抑郁疗效，并降低神经认知障碍的风险。该双盲研究将受试者随机分配至三个治疗组：600、700和800 mA（活性对照药物）。临床，认知和成像评估进行前，中期和后ECT。受试者被诊断为重度抑郁症，年龄范围在50至80岁之间，并符合ECT的临床适应症。相对于600 mA组，700 mA和800 mA组的抑郁结局有所改善。振幅组在主要认知结局变量、霍普金斯言语学习测验修订版（HVLT-R）保留原始评分方面无差异。然而，次要认知结果，如Delis Kaplan执行功能系统（DKEFS）字母和类别流畅性测量显示800 mA组的认知障碍。结果显示抑郁（更高振幅更好）和认知（更低振幅更好）相关结果分离。未来的工作是必要的，以阐明振幅，电场，神经可塑性和临床结果之间的关系。
Electroconvulsive therapy (ECT) pulse amplitude, which determines the induced electric field magnitude in the brain, is currently set at 800–900 milliamperes (mA) on modern ECT devices without any clinical or scientific rationale. The present study assessed differences in depression and cognitive outcomes for three different pulse amplitudes during an acute ECT series. We hypothesized that the lower amplitudes would maintain the antidepressant efficacy of the standard treatment and reduce the risk of neurocognitive impairment. This double-blind investigation randomized subjects to three treatment arms: 600, 700, and 800 mA (active comparator). Clinical, cognitive, and imaging assessments were conducted pre-, mid- and post-ECT. Subjects had a diagnosis of major depressive disorder, age range between 50 and 80 years, and met clinical indication for ECT. The 700 and 800 mA arms had improvement in depression outcomes relative to the 600 mA arm. The amplitude groups showed no differences in the primary cognitive outcome variable, the Hopkins Verbal Learning Test-Revised (HVLT-R) retention raw score. However, secondary cognitive outcomes such as the Delis Kaplan Executive Function System (DKEFS) Letter and Category Fluency measures demonstrated cognitive impairment in the 800 mA arm. The results demonstrated a dissociation of depression (higher amplitudes better) and cognitive (lower amplitudes better) related outcomes. Future work is warranted to elucidate the relationship between amplitude, electric field, neuroplasticity and clinical outcomes.
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影响因子：
4.7
作者：
Kellner, Charles H.;Popeo, Dennis M.;Gamss, Stephen
通讯作者：
Gamss, Stephen
影响因子：
--
作者：
Lacritz, L H;Cullum, C M;Rosenberg, R N
通讯作者：
Rosenberg, R N
影响因子：
17.7
作者：
LIBERSON, WT
通讯作者：
LIBERSON, WT
DOI：
10.1017/s1355617705050782
发表时间：
2005-10-01
影响因子：
2.6
作者：
Benedict, RHB
通讯作者：
Benedict, RHB
影响因子：
5.3
作者：
Fekadu, Abebaw;Wooderson, Sarah;Cleare, Anthony J.
通讯作者：
Cleare, Anthony J.