Clinical Neuroscience of ECT (CNECT)

  CNECT, your Clinical Neuroscience of ECT blog, will be on hiatus from December 25-January 1 I look forward to reviewing the new and classic ECT literature with you in 2022. Happy holidays to all! Charles Kellner

 Out on PubMed, from authors in China and California, is this article: Magnetic Seizure Therapy Compared to Electroconvulsive Therapy for Schizophrenia: A Randomized Controlled Trial. Jiang J, Li J, Xu Y, Zhang B, Sheng J, Liu D, Wang W, Yang F, Guo X, Li Q, Zhang T, Tang Y, Jia Y, Daskalakis ZJ, Wang J, Li C. Front Psychiatry. 2021 Nov 25;12:770647. doi: 10.3389/fpsyt.2021.770647. eCollection 2021. PMID:  34899429 The abstract is copied below: Background: Magnetic seizure therapy (MST) is a potential alternative to electroconvulsive therapy (ECT). However, reports on the use of MST for patients with schizophrenia, particularly in developing countries, which is a main indication for ECT, are limited. Methods: From February 2017 to July 2018, 79 inpatients who met the DSM-5 criteria for schizophrenia were randomized to receive 10 sessions of MST (43 inpatients) or ECT (36 inpatients) over the course of 4 weeks. At baseline and 4-week follow-up, the Positive and Negative Syndrom...

 Out on PubMed, from an anesthesiologist in India, is this report: Utility of a novel airway collar in  electroconvulsive  therapy - A handsfree technique. Vaithialingam B. Korean J Anesthesiol. 2021 Dec 9. doi: 10.4097/kja.21481. Online ahead of print. PMID:  34883009   The pdf is here . This is an interesting technical innovation in anesthesia technique; whether it is necessary or helpful, I'm not sure. Perhaps the more interesting part of this technique is the insufflation device that replaces bag/mask ventilation of the patient, something touted during the current COVID pandemic to avoid aerosolization in the treatment room.  It would be good to hear some opinions as to whether this technique is regarded favorably as an addition to the possible technical approaches to ECT anesthesia, or if it just seems glitzy and not worth the bother... All followers of the ECT anesthesia literature will want to read this brief LTE.

LETTER TO THE EDITOR How to Reliably Predict Relapse After Electroconvulsive Therapy? Simon Lambrichts, MD a, *, Kristof Vansteelandt, PhD a , Jasmien Obbels, MSc a , and Pascal Sienaert, MD, PhD a J Clin Psychiatry 2022;83(1):21lr14269 To cite:  Lambrichts S, Vansteelandt K, Obbels J, et al. How to reliably predict relapse after electroconvulsive therapy?  J Clin Psychiatry . 2022;83(1):21lr14269. a KU Leuven, Department of Neurosciences, Research Group Psychiatry, Neuropsychiatry, Academic Center for ECT and Neuromodulation (AcCENT), University Psychiatric Center KU Leuven (UPC KU Leuven), Kortenberg, Belgium * Corresponding author:  Simon Lambrichts, MD, University Psychiatric Center KU Leuven (UPC KU Leuven), Leuvensesteenweg 517, 3070 Kortenberg, Belgium ( simon.lambrichts@upckuleuven.be ). To the Editor:  We thank Dr Andrade for his comment 1  on our study of relapse after abrupt discontinuation of maintenance electroconvulsive therapy (M-ECT) during the C...

 Out on PubMed, from investigators in Sweden, is this study: Cost-utility analysis of esketamine and  electroconvulsive  therapy in adults with treatment-resistant depression. Degerlund Maldi K, Asellus P, Myléus A, Norström F. BMC Psychiatry. 2021 Dec 7;21(1):610. doi: 10.1186/s12888-021-03601-8. PMID:  34876085 The abstract is copied below: Background: Electroconvulsive therapy (ECT) has long been used for treating individuals with treatment-resistant depression (TRD). Esketamine has recently emerged as a new treatment for TRD due to its rapid antidepressant effects. To further inform the decision regarding choice of treatment, this paper aims to evaluate whether ECT or esketamine is the more cost-effective option. Methods: The cost-effectiveness was derived as cost per quality-adjusted life-year (QALY) using a Markov model from a societal and life-time perspective. The incremental cost-effectiveness ratio (ICER) was calculated. Health states included different dep...

 Out on PubMed, from investigators in Italy, is this paper: One century of healing currents into the brain from the scalp: From electroconvulsive therapy to repetitive transcranial magnetic stimulation for neuropsychiatric disorders. Di Iorio R, Rossi S, Rossini PM. Clin Neurophysiol. 2021 Nov 11;133:145-151. doi: 10.1016/j.clinph.2021.10.014. Online ahead of print. PMID:  3486451 The abstract is copied below: Electroconvulsive therapy (ECT) was applied for the first time in humans in 1938: after 80 years, it remains conceptually similar today except for modifications of the original protocol aimed to reduce adverse effects (as persistent memory deficits) without losing clinical efficacy. We illustrate the stages of development as well as ups and downs of ECT use in the last eighty years, and the impact that it still maintains for treatment of certain psychiatric conditions. Targeted, individualized and safe noninvasive neuromodulatory interventions are now possible for many n...

Out on PubMed, with a first author from Tennessee, is this review: A Scoping Review of Palliative Care for Adults with Huntington's Disease: Current Practice and Future Directions. El-Sourady M, Martin S, Wong HN, Carroll T. J Palliat Med. 2021 Nov 30. doi: 10.1089/jpm.2021.0308. Online ahead of print. PMID:  34847736 The abstract is copied below: Context: Huntington's disease (HD) is a neurodegenerative disorder characterized by mid-life onset, cognitive decline, and behavioral disturbance. Objective: We conducted a review of the end-of-life (EOL) experience of HD patients and their families. Methods: We searched 5 electronic databases. Eligible studies were published in English and contained outcomes related to PC, end-of-life (EOL), advance directives (ADs), symptom management, or hospice use for HD adults. Results: We screened 1566 studies, assessed 244 studies, and included 27 studies. Symptom Prevalence: Decedent data showed greater likelihood of pneumonia, choking, nutri...

Out on Pubmed, from investigators in China, is this study: Alteration of Whole Brain ALFF/fALFF and Degree Centrality in Adolescents With Depression and Suicidal Ideation After Electroconvulsive Therapy: A Resting-State fMRI Study. Li X, Yu R, Huang Q, Chen X, Ai M, Zhou Y, Dai L, Qin X, Kuang L. Front Hum Neurosci. 2021 Nov 11;15:762343. doi: 10.3389/fnhum.2021.762343. eCollection 2021. PMID:  34858155   The abstract is copied below: Major depressive disorder (MDD) is one of the most widespread mental disorders and can result in suicide. Suicidal ideation (SI) is strongly predictive of death by suicide, and electroconvulsive therapy (ECT) is effective for MDD, especially in patients with SI. In the present study, we aimed to determine differences in resting-state functional magnetic resonance imaging (rs-fMRI) in 14 adolescents aged 12-17 with MDD and SI at baseline and after ECT. All participants were administered the Hamilton Depression Scale (HAMD) and Beck Scale for Suici...

Out on PubMed, from investigators in the Midwest and New England, is this paper: Neuromodulation Strategies for the Treatment of Depression. Conroy SK, Holtzheimer PE. Am J Psychiatry. 2021 Dec;178(12):1082-1088. doi: 10.1176/appi.ajp.2021.21101034. PMID:  34855452 The abstract is copied below: For many decades, psychiatric treatment has been primarily guided by two major paradigms of psychopathology: a neurochemical paradigm leading to the development of medications and a psychological paradigm resulting in the development of psychotherapies. A third paradigm positing that psychiatric dysfunction results from abnormal communication within a network of brain regions that regulate mood, thought, and behavior has gained increased attention over the past several years and underlies the development of multiple neuromodulation and neurostimulation therapies. This neural circuit paradigm is not new. In the late 19th and early 20th centuries, it was a common way of understanding psychiatr...