Clinical Neuroscience of ECT (CNECT)

Out on PubMed, from authors at the Mayo Clinic, is this LTE:  Role of electroconvulsive therapy in patients with clozapine-refractory schizophrenia. Markota M , Croarkin PE, Gentry MT, Leung JG. Schizophr Res. 2024 May 21;269:130-131. doi: 10.1016/j.schres.2024.05.013. Online ahead of print. PMID:  38776722 The LTE is here . And here: This is a critique of a study published in Schizophrenia Research which concluded that ECT was ineffective in patients with clozapine-resistant schizophrenia (CRS). The arguments in this LTE are a bit convoluted, but boil down to saying that ECT works if the CRS is severe. One would have to think this is true, given both the extant literature and vast clinical experience.

  Out on PubMed, from clinicians in Indiana, is this case report: Electroconvulsive  Therapy in New Onset Refractory Status Epilepticus (NORSE) in a Pediatric Patient. Sun F, Eberhard S, Hanson AE, Walsh L, Jackman CT, Maue D, Conroy SK. Brain Stimul. 2024 May 17:S1935-861X(24)00088-3. doi: 10.1016/j.brs.2024.05.006. Online ahead of print. PMID:  38763413   The LTE is here . And here: Here is another report of the successful use of ECT for status epilepticus, this one in an 8-year old child. Please see also blog post of two days ago for the new review of ECT in status epilepticus.

 Out on PubMed, from researchers in Sweden, is this study: Suicidal behavior and all-cause mortality in depressed older adults aged 75+ treated with electroconvulsive therapy: A Swedish register-based comparison study. Hedna K, Jonson M, Sigström R, Levinsson A, Nordenskjöld A, Waern M. Int J Geriatr Psychiatry. 2024 May;39(5):e6102. doi: 10.1002/gps.6102. PMID:  38767969 The abstract is copied below: Objectives: Electroconvulsive therapy (ECT) is effective in treating late-life depression. There is limited research on suicidal behavior and all-cause mortality in the oldest old after ECT. Methods: Older adults aged 75 years and above who had been inpatients for moderate to severe depression between January 1, 2011, and December 31, 2017, were included in the study. We used exact and propensity score matching to balance groups. We compared suicidal behavior (fatal and non-fatal) and all-cause mortality in those who had received ECT and those with other depression treatments. Re...

 Out on PubMed, from authors in Malayasia and Austria, is this review: Electroconvulsive Therapy in Refractory and Super-Refractory Status Epilepticus in Adults: A Scoping Review. Ong MJY, Lee VLL, Teo SL, Tan HJ, Trinka E, Khoo CS. Neurocrit Care. 2024 May 20. doi: 10.1007/s12028-024-02003-4. Online ahead of print. PMID:  38769254   Review. The abstract is copied below: Background: Electroconvulsive therapy (ECT) has been suggested as a treatment option for refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE). Objective: The objective of this scoping review was to conduct an extensive literature review on the role of ECT as a treatment option for RSE and SRSE . Methods: We searched Ovid MEDLINE and Scopus for journal articles from database inception until February 2024. Articles were then selected based on predetermined inclusion and exclusion criteria. Results: We identified five retrospective case series with 28 adult patients receiving E...

Out on PubMed, from researchers in Italy, is this paper: Response to electroconvulsive therapy in elderly patients with late-onset bipolar disorder: The impact of cerebral small vessel disease. Brancati GE, Torrigiani S, Acierno D, Fustini C, Puglisi F, Elefante C, Lattanzi L, Medda P, Perugi G. Int J Geriatr Psychiatry. 2024 May;39(5):e6098. doi: 10.1002/gps.6098. PMID:   38777619   The abstract is copied below: Objectives: Cerebral Small Vessel Disease (CSVD) is a chronic, progressive vascular disorder that confers increased vulnerability to psychiatric syndromes, including late-life mood disorders. In this study, we investigated the impact of CSVD on electroconvulsive therapy (ECT) outcomes in patients with late-onset bipolar disorder (BD). Methods: A sample of 54 non-demented elderly patients (≥60 years) with late-onset BD and treatment-resistant major depression, mixed state, or catatonia who underwent bilateral ECT were included in this naturalistic observational study. ...

Out on PubMed, from authors in China, is this paper: Comparison of Effects of Propofol Combined with Different Doses of Esketamine for  ECT  in the Treatment of Depression: A Randomized Controlled Trial Protocol. Chen X, Zhou R, Lan L, Zhu L, Chen C, Zhang X, Han J, Xia L. Neuropsychiatr Dis Treat. 2024 May 17;20:1107-1115. doi: 10.2147/NDT.S463028. eCollection 2024. PMID:  38774255 The abstract is copied below: Objective: Major depressive disorder (MDD) is a common mood disorder. Electroconvulsive therapy (ECT) has a significant effect on treatment-resistant MDD. Esketamine may have potential advantages in improving the efficacy of ECT, and the strong affinity of this compound for NMDAR renders it a viable therapeutic option for the management of depression. This study aims to compare the effects of different doses of esketamine combined with propofol anesthesia versus propofol anesthesia alone in ECT, aiming to provide further insights for optimizing ECT and enhancing c...

Out On PubMed, in JECT, is this article: What Is Brain Damage and Does  Electroconvulsive  Therapy Cause It? Swartz CM. J ECT. 2024 May 21. doi: 10.1097/YCT.0000000000001019. Online ahead of print. PMID:   38771065   The abstract is copied below: Surveys show public misperceptions and confusion about brain damage and electroconvulsive therapy (ECT). Fictional movies have misrepresented ECT to suggest brain damage and to ridicule mental illness and psychiatric patients. "Brain damage" has become a colloquial expression without consistent meaning. In contrast, brain injury is the medical term for destruction of brain cells , such as from kinetic impact (concussion), hypoxia, or infection. Studies of both high-resolution magnetic resonance imaging (MRI) and enzyme assays find that causes of brain injury are accompanied by observable structural changes on MRI and elevated blood and cerebrospinal fluid levels of brain enzymes that leak from injured brain cells. Concussion...

 Out on PubMed, from authors in Australia, is this article: Electroconvulsive  Therapy in Transgender and Gender Diverse Population: A Case Report and Review of Literature. Draper L, Vikas A, Das S, Yadav S, Walker F, Bandilovska I. Case Rep Psychiatry. 2024 May 7;2024:5552781. doi: 10.1155/2024/5552781. eCollection 2024. PMID:  38746078 The abstract is copied below: Objective: Present a case of a transgender and gender diverse (TGD) individual receiving gender affirming hormone therapy (GAHT) who presented with first episode bipolar mania and received electroconvulsive therapy (ECT). To understand the safety and efficacy of ECT in the TGD population including those receiving GAHT through literature review. Materials and methods: Case report using informed consent from an individual TGD patient who received ECT. A review of the literature was conducted using PubMed, Embase, and Medline. Results: The case illustrated safe and effective ECT use in a TGD individual receiving...

 Out on PubMed,  in AM J Psych, is this article: Genome-Wide Association Study of Treatment-Resistant Depression: Shared Biology With Metabolic Traits. Kang J, Castro VM, Ripperger M, Venkatesh S, Burstein D, Linnér RK, Rocha DB, Hu Y, Wilimitis D, Morley T, Han L, Kim RY, Feng YA, Ge T, Heckers S, Voloudakis G, Chabris C, Roussos P, McCoy TH, Walsh CG, Perlis RH, Ruderfer DM. Am J Psychiatry. 2024 May 15:appiajp20230247. doi: 10.1176/appi.ajp.20230247. Online ahead of print. PMID:  38745458 The abstract is copied below: Objective: Treatment-resistant depression (TRD) occurs in roughly one-third of all individuals with major depressive disorder (MDD). Although research has suggested a significant common variant genetic component of liability to TRD, with heritability estimated at 8% when compared with non-treatment-resistant MDD, no replicated genetic loci have been identified, and the genetic architecture of TRD remains unclear. A key barrier to this work has been the pa...

 Out on PubMed, in Acta, is this editorial: Electroconvulsive therapy ( ECT ) for mania: Hiding in plain sight. Kellner CH. Acta Psychiatr Scand. 2024 May 14. doi: 10.1111/acps.13693. Online ahead of print. PMID:  38744445   The editorial is here . And here: I was asked to write this editorial, and pleased to do so, to spotlight the work of Katarzyna Popiolek and colleagues on ECT in mania. The original article was on the blog last week. Dr. Popiolek recently defended her doctoral dissertation, "Electroconvulsive therapy for bipolar disorder." Kudos to her for this important work in our field.

 Out on PubMed, from researchers in Sweden, is this study: Association between electroconvulsive therapy and time to readmission after a manic episode. Popiolek K , Arnison T, Bejerot S, Fall K, Landén M, Nordenskjöld A. Acta Psychiatr Scand. 2024 Apr 11. doi: 10.1111/acps.13689. Online ahead of print. PMID:  38604233 The abstract is copied below: Objective: The majority of patients hospitalized for treatment of a manic episode are readmitted within 2 years despite maintenance treatment. Electroconvulsive therapy (ECT) has been associated with lower rehospitalization rates in some psychiatric conditions, but its association with readmission after a manic episode has not been investigated. Therefore, the aim of this study was to determine whether the time to readmission in patients with mania treated with ECT was longer than in patients not treated with ECT and whether there were subgroups of patients that benefited more. Methods: This was a nationwide register-based, observati...

  Here is the link to the program: https://nact.se/next-meeting/scientific-programme/ And here is the program: The Nordic Association For Convulsive Therapy (NACT) is one of the biggest ECT societies in the world, and their meetings are among the best. This looks to be an excellent program, as per their usual. I hope to be able to blog about some of these presentations, if the slide sets become available.  I encourage all ECT practitioners to consider going to a future NACT meeting in person; I'm sure you would enjoy it and find it very rewarding.