Clinical Neuroscience of ECT (CNECT)

Out on PubMed, from researchers in Austria and Germany, is this paper: Meta-analysis of brain structural changes after  electroconvulsive  therapy in depression. Gryglewski G, Lanzenberger R, Silberbauer LR, Pacher D, Kasper S, Rupprecht R, Frey R, Baldinger-Melich P. Brain Stimul. 2021 Jun 10:S1935-861X(21)00114-5. doi: 10.1016/j.brs.2021.05.014. Online ahead of print. PMID:  34119669 The abstract is copied below: Background: Increases in the volume of the amygdala and hippocampus after electroconvulsive therapy (ECT) are among the most robust effects known to the brain-imaging field. Recent advances in the segmentation of substructures of these regions allow for novel insights on the relationship between brain structure and clinical outcomes of ECT. Objective: We aimed to provide a comprehensive synthesis of evidence available on changes in brain structure after ECT, including recently published data on hippocampal subfields. Methods: A meta-analysis of published studie...

 Out on PubMed, from the well-known Harvard group, is this study: Changes in seizure duration during acute course electroconvulsive therapy. Luccarelli J, McCoy TH Jr, Seiner SJ, Henry ME. Brain Stimul. 2021 Jun 10:S1935-861X(21)00117-0. doi: 10.1016/j.brs.2021.05.016. Online ahead of print. PMID:  34119670 The abstract is copied below: Background: Seizure duration has long been measured as a potential marker of ECT treatment efficacy, with concern that short seizures may be clinically ineffective. Relatively small studies have documented a trend towards shorter seizures during acute course ECT, but data from large cohorts would help provide normative data on seizure duration changes during treatment. Objective: This study analyzes the effects of age, sex, ECT dose, and treatment number on the duration of electrographic seizures during acute course ECT in a large single-center cohort. Methods: A single-center retrospective chart review was conducted of adult patients receiving...

 Out on PubMed, from researchers in Texas, is this paper: A Novel Refractory Mood Disorders and Electroconvulsive Therapy Elective for Medical Students: Fighting Stigma through Experience. Yau BN, Rong C, Findley JC, Selek S. Psychiatr Q. 2021 Jun 7. doi: 10.1007/s11126-021-09929-4. Online ahead of print. PMID:  34097246 The abstract is copied below: Treatment resistant mood disorders (TRMD) have a significant impact on patients and society. Electroconvulsive therapy (ECT) has been shown to be effective for treatment resistant depression (TRD). Despite the effectiveness and safety of ECT, there remains significant stigma surrounding its use. Studies worldwide have shown that many medical students receive their knowledge from the media, which often portrays ECT in a negative light, and very few have exposure to ECT prior to their psychiatric clinical rotations . In this article we highlight the importance of medical education and introduce a novel approach in helping to fight t...

 Out on PubMed, from clinicians in India, is this study: Bi-Spectral Index-Guided Comparison of Propofol versus Etomidate for Induction in Electroconvulsive Therapy. Rajpurohit V, Chaudhary K, Kishan R, Kumari K, Sethi P, Sharma A. Anesth Essays Res. 2020 Jul-Sep;14(3):504-509. doi: 10.4103/aer.AER_92_20. Epub 2021 Mar 22. PMID:  34092866 The abstract is copied below: Background: Previous studies have compared varying doses of propofol and etomidate for electroconvulsive therapy (ECT) without monitoring the depth of anesthesia. Seizure duration may vary with the depth of anesthesia. Aim: This study aimed to compare the effects of bi-spectral index (BIS)-guided induction with propofol and etomidate on various parameters of ECT. Settings and design: This was a prospective, randomized, double-blind study. Materials and methods: Sixty patients undergoing ECT were randomly allocated to two groups. Group P received intravenous propofol 1-2 mg.kg -1 and Group E received etomidate 0.1...

Out on PubMed, from researchers in China, is this review: Magnetic seizure therapy for treatment-resistant depression. Jiang J, Zhang C, Li C, Chen Z, Cao X, Wang H, Li W, Wang J. Cochrane Database Syst Rev. 2021 Jun 16;6:CD013528. doi: 10.1002/14651858.CD013528.pub2. PMID:  34131914   The abstract is copied below: Background: Magnetic seizure therapy (MST) is a potential alternative to electroconvulsive therapy (ECT). Reports to date on use of MST for patients with treatment-resistant depression (TRD) are limited. Objectives: To evaluate the effects of MST in comparison with sham-MST, antidepressant, and other forms of electric or magnetic treatment for adults with TRD. Search methods: In March 2020, we searched a wide range of international electronic sources for published, unpublished, and ongoing studies. We hand-searched the reference lists of all included studies and relevant systematic reviews and conference proceedings of the Annual Meeting of the American College of N...

 Out on PubMed is this review: Evaluation and treatment of older-age bipolar disorder: a narrative review. Tampi RR, Joshi P, Bhattacharya G, Gupta S. Drugs Context. 2021 May 27;10:2021-1-8. doi: 10.7573/dic.2021-1-8. eCollection 2021. PMID:  34113387 The abstract is copied below: Objectives: This narrative review aims to synthesize information from the literature regarding older-age bipolar disorder (OABD) in order to provide up-to-date information on this important illness. Methods: We searched Ovid (Medline, Embase and PsychInfo) on October 1, 2020, using the keywords "bipolar disorder", "older adults" and "elderly" to identify relevant articles on OABD. Additionally, the bibliography of identified articles was reviewed for pertinent studies. Discussions: OABD is a term that is used to describe bipolar disorder (BD) occurring amongst individuals ≥50 years of age. Evidence indicates that OABD accounts for a quarter of all cases of BD. When compared to in...

Methylome-wide change associated with response to electroconvulsive therapy in depressed patients. Sirignano L, Frank J, Kranaster L, Witt SH, Streit F, Zillich L, Sartorius A, Rietschel M, Foo JC. Transl Psychiatry. 2021 Jun 5;11(1):347. doi: 10.1038/s41398-021-01474-9. PMID:  34091594 The abstract is copied below: Electroconvulsive therapy (ECT) is a quick-acting and powerful antidepressant treatment considered to be effective in treating severe and pharmacotherapy-resistant forms of depression. Recent studies have suggested that epigenetic mechanisms can mediate treatment response and investigations about the relationship between the effects of ECT and DNA methylation have so far largely taken candidate approaches. In the present study, we examined the effects of ECT on the methylome associated with response in depressed patients (n = 34), testing for differentially methylated CpG sites before the first and after the last ECT treatment. We identified one differentially methylate...

Out on PubMed, from researchers at Penn State College of Medicine and Yale School of Medicine, is this study: Does Electroconvulsive Therapy for Patients with Mood Disorders Extend Hospital Length of Stays and Increase Inpatient Costs? Agbese E, Leslie DL, Ba DM, Rosenheck R. Adm Policy Ment Health. 2021 Jun 5. doi: 10.1007/s10488-021-01145-3. Online ahead of print. PMID:  34089432 The abstract is copied below: Although randomized trials have shown that electroconvulsive therapy (ECT) is an effective and underused treatment for mood disorders, its impact on inpatient length of stay (LOS) and hospital costs are not fully understood. We analyzed private insurance claims of patients hospitalized for mood disorders who had continuous insurance for three months prior to an index hospitalization and six months after discharge (N = 24,249) . Propensity score weighted linear models were used to examine the association of any ECT use, the number of ECT treatments, and time to first ECT trea...

Out on PubMed, in Acta Psychiatrica Scandinavica, from researchers in Belgium, is this study: Relapse after abrupt discontinuation of maintenance electroconvulsive therapy during the COVID-19 pandemic. Lambrichts S, Vansteelandt K, Crauwels B, Obbels J, Pilato E, Denduyver J, Ernes K, Maebe PP, Migchels C, Roosen L, Buggenhout S, Bouckaert F, Schrijvers D, Sienaert P. Acta Psychiatr Scand. 2021 Jun 4. doi: 10.1111/acps.13334. Online ahead of print. PMID:  34086984 The abstract is copied below: Objective: Maintenance electroconvulsive therapy (M-ECT) is considered an effective relapse prevention strategy in severe mood and psychotic disorders. How long M-ECT should be continued, and what the outcome is after its discontinuation has not been adequately studied. In our tertiary psychiatric hospital, M-ECT treatments were suspended at the start of the COVID-19 pandemic. We aimed to determine the 6-month relapse rate and time to relapse after abrupt discontinuation of M-ECT and to asses...

 Out on PubMed, from the PRIDE Study Group, is this study: Longitudinal Neurocognitive Effects of Combined Electroconvulsive Therapy ( ECT ) and Pharmacotherapy in Major Depressive Disorder in Older Adults: Phase 2 of the PRIDE Study. Lisanby SH, McClintock SM, McCall WV, Knapp RG, Cullum CM, Mueller M, Deng ZD, Teklehaimanot AA, Rudorfer MV, Bernhardt E, Alexopoulos G, Bailine SH, Briggs MC, Geduldig ET, Greenberg RM, Husain MM, Kaliora S, Latoussakis V, Liebman LS, Petrides G, Prudic J, Rosenquist PB, Sampson S, Tobias KG, Weiner RD, Young RC, Kellner CH; Prolonging Remission in Depressed Elderly (PRIDE) Work Group. Am J Geriatr Psychiatry. 2021 May 17:S1064-7481(21)00293-1. doi: 10.1016/j.jagp.2021.04.006. Online ahead of print. PMID:  34074611 The abstract is copied below: Objective: There is limited information regarding neurocognitive outcomes of right unilateral ultrabrief pulse width electroconvulsive therapy (RUL-UB ECT) combined with pharmacotherapy in older adults w...

I am going to refrain from commenting on this LTE exchange in the ANZJP; the divergent opinions are crystal clear. I just want the ECT community to be aware that these letters are in print. Your comments would be most welcome, thanks...

 Out on PubMed is this case report: Lithium-Associated Hyperparathyroidism Followed by Catatonia. Thippaiah SM, Fargason RE, Gude JG, Muralidhara SN, Birur B. AACE Clin Case Rep. 2020 Dec 19;7(3):189-191. doi: 10.1016/j.aace.2020.12.010. eCollection 2021 May-Jun. PMID:  34095485   The abstract is copied below: Objective: To familiarize the medical community with the less common adverse effects of lithium on parathyroid function, we present a case of lithium-associated hyperparathyroidism followed by the development of new-onset catatonia in a patient with schizoaffective disorder. Methods: To allow for the safe resumption of lithium, the patient received laboratory screening of serum lithium, blood urea nitrogen, serum creatinine, calcium, and thyroid-stimulating hormone levels. The hypercalcemia was evaluated by measuring parathyroid hormone (PTH), ionized calcium, and 25-hydroxy vitamin D levels. Results: A 58-year-old man with longstanding schizoaffective disorder was ...