ECT in Refractory OCD: New Study From China is Uninterpretable

Out on PubMed, from researchers in China, is this study: 

Effect of modified electroconvulsive therapy on neuro metabolites and magnetic resonance spectroscopy imaging signals in patients with refractory obsessive-compulsive disorder.

Liu D, Liang R, Bai S, Lan B, Liu G, Wang D, Yuan S, Sun W, Li G.J Affect Disord. 2021 Oct 10:S0165-0327(21)01074-0. doi: 10.1016/j.jad.2021.10.005. Online ahead of print.PMID: 34644618

The abstract is copied below:

Objective: This study was aimed to investigate the effect of modified electroconvulsive therapy (MECT) on neurometabolites and magnetic resonance spectroscopy imaging (MRSI) signals in patients with refractory obsessive-compulsive disorder (OCD).

Methods: From January 2018 to January 2020, 64 patients with OCD consecutively treated in the Psychiatric Department of our hospital were randomly divided into a study group treated with MECT and a control group treated with drugs alone. The obsessive-compulsive state, anxiety and depression, MRSI signals, neuro metabolite ratio, and quality of life were all observed in both groups.

Results: After treatment, the scores of compulsive behaviors, obsessive thoughts, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) in the study group were lower than those of the control group. The N-acetylaspartate to creatine ratio (NAA/Cr) value was increased in the study group while it was decreased in the control group. In addition, the choline/creatine (Cho/Cr) ratio was decreased in the study group, whereas it was increased in the control group (P < 0.05). Compared to the control group, the study group's social and physiological functions, role limitations, and overall health scores were significantly higher. The amplitudes of low-frequency fluctuations were reduced considerably following MECT treatment in the right anterior cerebellar lobe, left inferior parietal lobule, right paracentral lobule, and right precentral gyrus.

Conclusions: MECT can effectively relieve obsessive-compulsive symptoms, regulate neuro metabolite levels, improve quality of life, reduce anxiety and depression, and is linked to changes in right brain functional activities.

Keywords: Electroconvulsive Therapy; Magnetic Resonance Spectroscopy; Obsessive-Compulsive Disorder; choline; creatine.





I am shocked that this paper is actually scheduled to be published in a reputable journal. The abstract seems reasonable, but the paper itself is so poorly translated and edited that the clinical science is hard to believe. It is hard to know if this study actually benefited the patients as described- the presentation is so primitive that one just cannot tell. The references are completely idiosyncratic and there is no review of the relevant literature of ECT in OCD.
Please read the above selection of quotes-and there are many more.

I am all for new data to show that ECT is helpful for patients with refractory OCD, but this paper has somehow eluded the editing and peer review process in a major journal.

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