ECT For Movement Disorders: New Review

Out on PubMed is this review from Spain:

Electroconvulsive Therapy and Movement Disorders. New Perspectives on A Time-Tested Therapy.

Garcia Ruiz PJ.Mov Disord Clin Pract. 2021 Mar 9;8(4):521-524. doi: 10.1002/mdc3.13180. eCollection 2021 May.PMID: 3398178

The abstract is copied below:

Electroconvulsive therapy (ECT) has been a very well known therapy in Psychiatry for over 80 years. ECT is considered useful in treating acute mania, severe depression and other psychiatric conditions. Over time, this therapy has also been used in several movement disorders including Parkinson disease (PD) and Huntington disease (HD). In this brief review, I summarize the recent History and evolution of ECT, its proven and potential applications in movement disorders as well as its potential mechanisms.

And from the text:

ECT is, at present, a well-established treatment for psychiatric disorders and has been increasingly used for some movement disorders including PD.21,35–41 However, the level of evidence has been modest, at best, mainly due to low quality and heterogeneity of available data. Despite these caveats, there are a growing number of anecdotal reports and at least one controlled study suggesting that ECT might play some role in PD.21,35–41 It seems clear that a well-planned controlled study might definitely shed light on the role of this technique in PD. It is worth recalling, that after all, we used antiparkinsonian techniques (eg, deep brain stimulation, infusion pumps of levodopa-carbidopa intestinal gel or apomorphine) for long time before their positive effect was statistically finally confirmed. In addition, it is worth to remember that the exact mechanisms of ECT are unknown, but also the mechanisms of deep brain stimulation 58–60 or magnetic stimulation, are also poorly understood.61–63 ECT may be found to play some role in movement disorders, especially PD, provided a definite confirmation of efficacy is reached. A well planned controlled study with ECT in PD is not easy to carry out; there are limitations such as the difficulty to obtain a “sham” group and the high placebo effect, but other studies have been recently completed in PD (including infusion pumps of levodopa-carbidopa intestinal gel and apomorphine) showing that placebo controlled trials can be conducted even with complex techniques.64,65 Finally, some authors suggest that ECT has been underused, even in those proved applications such as severe refractory depression. Probably, cultural reason and lack of interest due to its low price may partially explain these facts.

This is a short, somewhat idiosyncratic, review of ECT for movement disorders. It is written by a neurologist from Madrid, who is very well published in many aspects of Parkinson's Disease (PD). Anything that brings ECT to the attention of other neurologists in a good way is worth having in the literature.

The journal, Movement Disorders Clinical Practice is the journal of the International Parkinson and Movement Disorder Society.

[The International Parkinson and Movement Disorder Society (MDS) is pleased to announce that the Movement Disorders Journal impact factor has increased to 8.679, now ranking 11 out of 204 Clinical Neurology titles, according to the 2019 Clarivate Analytics InCites Journal Citation Reports rankings.]

For a quick reminder about the literature of ECT in PD, this is worth a read, ~5 minutes.