Clinical Neuroscience of ECT (CNECT)

 Out on PubMed, from German authors, is this review: Catatonia and  ECT  across the lifespan. Karl S, Sartorius A, Aksay SS. Schizophr Res. 2023 Apr 20:S0920-9964(23)00157-3. doi: 10.1016/j.schres.2023.04.004. Online ahead of print. PMID:  37087393 The abstract is copied below: Electroconvulsive therapy (ECT) is a safe and effective treatment for catatonia with high response rates. Although empirical data suggest that tolerability and efficacy are at least as good as in adults, ECT treatment of children, adolescents, and geriatric patients seems to pose a specific challenge for many practitioners . This article intends to explore and discuss reasons hindering the use of ECT in these patient groups, give an overview on the use of ECT to treat catatonia and provide practical advice on ECT in children, adolescents, and geriatric patients for the treatment of catatonia. Classification of catatonia as a subform of schizophrenia and a diagnostic overlap with other common c...

Out on PubMed, is this LTE: Commentary on 'Information flow and dynamic functional connectivity during electroconvulsive therapy in patients with depression'. Read J. J Affect Disord. 2023 Apr 20:S0165-0327(23)00478-0. doi: 10.1016/j.jad.2023.04.017. Online ahead of print. PMID:  37086793   While I hate to be complicit in perpetuating JR's oxygen supply, it is good to be aware of this. It comes from sloppy referencing, using a Read citation when not appropriate. But why the editors of the Journal of Affective Disorders would allow him to rant away in this LTE is hard to understand, and very unfortunate.

Out on PubMed, from authors in France and Canada, is this case report: Rapid and efficient treatment of post-traumatic stress disorder induced by anaesthesia awareness with recall using reconsolidation therapy. Laurin A, Bulteau S, Dumont R, Brunet A, Sauvaget A. Br J Anaesth. 2023 Apr 18:S0007-0912(23)00136-8. doi: 10.1016/j.bja.2023.03.013. Online ahead of print. PMID:  37080870 The article is here . And here: This report describes an extremely interesting and potentially important procedure. If this really works for treating anesthesia awareness with recall (AAWR), then it will be very helpful for allowing patients to continue needed ECT after such an experience. The theoretical implications for treating PTSD more broadly are enormous. The report is short on details of what actually happened during the ECT, but no matter, it is still very much worthwhile to read. Of course, we should do everything possible to prevent AAWR in the first place, with close attention to exc...

 Out on PubMed, from clinicians in Germany, is this case report: Bifrontal electroconvulsive therapy leads to improvement of cerebral glucose hypometabolism in frontotemporal dementia with comorbid psychotic depression - a case report. Schröder S, Bönig L, Proskynitopoulos PJ, Janke E, Heck J, Mahmoudi N, Groh A, Berding G, Wedegärtner F, Deest-Gaubatz S, Maier HB, Bleich S, Frieling H, Schulze Westhoff M. BMC Psychiatry. 2023 Apr 20;23(1):279. doi: 10.1186/s12888-023-04759-z. PMID:  37081424   The abstract is copied below: Background: Differentiating depression and dementia in elderly patients represents a major clinical challenge for psychiatrists. Pharmacological and non-pharmacological treatment options for both conditions are often used cautiously due to fear of adverse effects. If a clinically indicated therapy is not initiated due to fear of adverse effects, the quality of life of affected patients may significantly be reduced. Case presentation: Here, we describe ...

 Your blogger will be on hiatus for a few days, please check back soon. In the meantime, I encourage you to search PubMed for new articles and review prior blog posts of interest.  Thanks!

 Out on PubMed, in JECT, is this response: In Reply to Dr. Kellner, Neuroimaging Prior to  ECT : Good for One, but Maybe Not for All? Aloysi AS, Majeske M, Soleimani L, Banerjee R, Appel JM, Bryson E. J ECT. 2023 Apr 14. doi: 10.1097/YCT.0000000000000923. Online ahead of print. PMID:  37053439 The response is here . And here. Here is the final part of this literature exchange. I would very much like to hear opinions from blog readers, thanks.

Out on PubMed, in JECT, is my response to Dr. Aloysi and colleagues: Neuroimaging Prior to  Electroconvulsive   Therapy: Good for One, But Maybe Not for All? Kellner CH. J ECT. 2023 Apr 14. doi: 10.1097/YCT.0000000000000912. Online ahead of print. PMID:  37053459 The response is here . And here: Here is my response to the piece by Drs. Aloysi and colleagues that I blogged about yesterday.

Out on PubMed, in JECT, from authors at Mount Sinai, is this commentary: Neuroimaging Prior to ECT: Time to Reconsider? Aloysi AS , Majeske M, Soleimani L, Banerjee R, Appel JM, Bryson E. J ECT. 2023 Apr 14. doi: 10.1097/YCT.0000000000000915. Online ahead of print. PMID:  37053461 The commentary is here . And here: Here is an interesting and thoughtful commentary by my colleagues at Mount Sinai. My opinion about this issue is somewhat different from theirs, and a letter-to-the-editor that I wrote in response will be the subject of another blog post in the near future. Please read this carefully and consider what your position is in your practice, thanks.

Ketamine vs Electroconvulsive Therapy for Major Depressive Episode: A Systematic Review and Meta-analysis. Menon V, Varadharajan N, Faheem A, Andrade C. JAMA Psychiatry. 2023 Apr 12. doi: 10.1001/jamapsychiatry.2023.0562. Online ahead of print. PMID:  37043224 The abstract is copied below: Importance: The relative efficacy of ketamine and electroconvulsive therapy (ECT) in adults with major depressive episode (MDE) needs clarification. Objective: To compare depression rating outcomes with ketamine vs ECT in adults with MDE and to compare response and remission rates, number of sessions to response and remission, and adverse effects. Data sources: Two investigators independently systematically searched MEDLINE, ScienceDirect, and Google Scholar databases using a combination of relevant Medical Subject Headings terms and free-text keywords from database inception through May 15, 2022, to identify relevant English-language trials. Study selection: Parallel-group randomized clinical tr...

 Out on PubMed, from investigators in Boston and Barcelona, is this study: Brain volumetric correlates of  electroconvulsive  therapy versus transcranial magnetic stimulation for treatment-resistant depression. Cano M, Lee E, Funes C, Barbour T, Ellard KK, Andreou B, Uribe S, Henry ME, Seiner S, Cardoner N, Soriano-Mas C, Camprodon JA. J Affect Disord. 2023 Apr 4:S0165-0327(23)00449-4. doi: 10.1016/j.jad.2023.03.093. Online ahead of print. PMID:   37024015 The abstract is copied below: Background: Electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) are effective neuromodulation therapies for treatment-resistant depression (TRD). While ECT is generally considered the most effective antidepressant, rTMS is less invasive, better tolerated and leads to more durable therapeutic benefits. Both interventions are established device antidepressants, but it remains unknown if they share a common mechanism of action. Here we aimed to compare ...

The impact of treatment resistance on outcome and course of electroconvulsive therapy in major depressive disorder. Rovers JJE, Vissers P, Loef D, van Waarde JA, Verdijk JPAJ, Broekman BFP, Vergouwen ACM, Oudega ML, van Exel E, Coenen R, Everaerd DS, Tendolkar I, Dols A, van Eijndhoven PFP. Acta Psychiatr Scand. 2023 Mar 30. doi: 10.1111/acps.13550. Online ahead of print. PMID:  3702042 The abstract is copied below: Introduction: Major depressive disorder (MDD) is a common psychiatric disorder. Despite several treatment options, a subgroup of patients will not respond to the commonly used antidepressant treatments and thus express treatment resistance (TRD). TRD can be quantified with the Dutch Measure for Treatment Resistance in Depression (DM-TRD). Electroconvulsive therapy (ECT) is an effective treatment for MDD, also in TRD. Yet, the position of ECT as "treatment-of-last-resort" may decrease the likelihood of beneficial outcome. Our aim was to investigate the association...

 Out on PubMed, from investigators in Taiwan, is this study: Right-side frontal-central cortical hyperactivation before the treatment predicts outcomes of antidepressant and electroconvulsive therapy responsivity in major depressive disorder. Tsai HJ, Yang WC, Tsai SJ, Lin CH, Yang AC. J Psychiatr Res. 2023 Mar 14;161:377-385. doi: 10.1016/j.jpsychires.2023.03.023. Online ahead of print. PMID:  37012197 The abstract is copied below: Major depressive disorder places a great burden on healthcare resources worldwide. Antidepressants are the first-line treatment for major depressive disorder, but if patients don't respond adequately, brain stimulation therapy may be needed as second-line treatment. Digital phenotyping in patients with major depressive disorder will aid in the timely prediction of treatment effectiveness. This study explored electroencephalographic (EEG) signatures that diversify depression treatment responsivity, including antidepressant administration or brain st...

Out on PubMed, from Turkish authors, is this case report: Non-convulsive Status Epilepticus as a Complication of Electroconvulsive Therapy: A Case Report and Review of the Literature. Saltoğlu T, Şenol B, Koc G. Cureus. 2023 Mar 1;15(3):e35639. doi: 10.7759/cureus.35639. eCollection 2023 Mar. PMID:  37009391 The abstract is copied below: Electroconvulsive therapy (ECT) is a highly effective treatment option among the biological treatments introduced in psychiatry. It has been used successfully to treat neurological conditions such as epilepsy, Parkinson's disease, and major psychiatric disorders. Non-convulsive status epilepticus can be seen as a complication after ECT, although it rarely occurs. Due to its rarity, this complication is not yet well understood, is challenging to diagnose, and information about treatment options is limited. Here, we present a 29-year-old patient with no previous neurological disease and a history of schizophrenia and refractory psychosis on clozapine...

Out on PubMed, from the harvard group, is this study: The use of electroconvulsive therapy for children and adolescents in general hospitals: A 2019 kids' inpatient database analysis. Luccarelli J, McCoy TH Jr, Henry ME, Smith F, Beach SR, Fernandez-Robles C. Gen Hosp Psychiatry. 2023 Mar 26;82:95-100. doi: 10.1016/j.genhosppsych.2023.03.012. Online ahead of print. PMID:  370044 The abstract is copied below: Objective:  Objective:Electroconvulsive therapy (ECT) devices are classified as class II (moderate risk) for the treatment of depressive disorders and catatonia in patients aged 13 and older, but it is unknown how often the treatment is utilized by child and adolescent patients. The aim of this study was to examine the demographics of child and adolescent hospitalizations involving ECT, the medical and psychiatric comorbidities of these hospitalizations, and the overall number of treatments administered per hospitalization. Method: The 2019 Kids' Inpatient Database, a nati...

Out on PubMed, from investigators in China, is this study: Electroconvulsive therapy knowledge and attitudes among patients and caregivers in South China: A preliminary study. Deng CJ, Nie S, Mai JX, Huang X, Huang XB, Zheng W. Front Psychiatry. 2023 Mar 13;14:1145301. doi: 10.3389/fpsyt.2023.1145301. eCollection 2023. PMID:  36993925 The abstract is copied below: Background: Electroconvulsive therapy (ECT) is a safe and effective therapy for individuals suffering from major psychiatric disorders, but attitudes towards ECT among patients and caregivers have not been well studied. This study was conducted to elucidate patient and caregiver knowledge and attitudes concerning ECT in South China. Methods: The sample comprised 92 patients diagnosed with major psychiatric disorders and their caregivers (n = 92). Participants completed questionnaire measures of knowledge and attitudes related to ECT. Results: Information before ECT was inadequately provided to both caregivers and patients...