MST vs. ECT For Schizophrenia: Clinical Trial From China

 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 Syndrome Scale (PANSS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to assess symptom severity and cognitive functions, respectively. Results: Seventy-one patients who completed at least half of the treatment protocol were included in the per-protocol analysis. MST generated a non-significant larger antipsychotic effect in terms of a reduction in PANSS total score [g = 0.17, 95% confidence interval (CI) = -0.30, 0.63] and response rate [relative risk (RR) = 1.41, 95% CI = 0.83-2.39]. Twenty-four participants failed to complete the cognitive assessment as a result of severe psychotic symptoms. MST showed significant less cognitive impairment over ECT in terms of immediate memory (g = 1.26, 95% CI = 0.63-1.89), language function (g =1.14, 95% CI = 0.52-1.76), delayed memory (g = 0.75, 95% CI = 0.16-1.35), and global cognitive function (g = 1.07, 95% CI = 0.45-1.68). The intention-to-treat analysis generated similar results except for the differences in delayed memory became statistically insignificant. Better baseline cognitive performance predicted MST and ECT response. Conclusions: Compared to bitemporal ECT with brief pulses and age-dose method, MST had similar antipsychotic efficacy with fewer cognitive impairments, indicating that MST is a promising alternative to ECT as an add-on treatment for schizophrenia. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT02746965.
Keywords: cognitive functions; electroconvulsive therapy; magnetic seizure therapy; randomized controlled trial; schizophrenia.

The pdf is here.

And from the text:

This paper describes a study with several methodological limitations, so the results must be interpreted cautiously. MST may work well for schizophrenia and may have a different cognitive tolerability profile than ECT. There is not much more to say here about the results of this study.

MST remains experimental and the complexity of the device may preclude its ever coming into widespread use. If it does, I hope it will be considered a form of ECT.

Perhaps the most interesting aspect of this paper is the use of ECT for schizophrenia, much more common in Asia than elsewhere in the world.

A full read of this paper, recommended only for followers of the MST literature, will be ~20 minutes.