Clinical Neuroscience of ECT (CNECT)

Out on PubMed, from authors in China, is this paper:  Efficacy and safety of eight enhanced therapies for treatment-resistant depression: A systematic review and network meta-analysis of RCTs. Guo Q, Guo L, Wang Y, Shang S. Psychiatry Res. 2024 Jun 20;339:116018. doi: 10.1016/j.psychres.2024.116018. Online ahead of print. PMID:  38924903 The abstract is copied below: Background: Treatment-Resistant Depression (TRD) challenges psychiatric treatment, with existing guidelines covering only a subset of augmentation strategies. Methods: A network meta-analysis following PRISMA guidelines examined the efficacy and safety of TRD treatments, analyzing 72 randomized controlled trials from eight databases, assessing response and remission rates, tolerability, and safety through the Cochrane Risk of Bias Tool and CINeMA framework. Findings: Including 12,105 participants, the analysis highlighted ECT, Ketamine, Esketamine, and Psilocybin as superior first-line treatments due to their opti...

 Out on PubMed, from researchers in Switzerland and the US, is this paper: Analyzing Fractal Dimension in  Electroconvulsive  Therapy: Unraveling Complexity in Structural and Functional Neuroimaging. Denier N, Grieder M, Jann K, Breit S, Mertse N, Walther S, Soravia LM, Meyer A, Federspiel A, Wiest R, Bracht T. Neuroimage. 2024 Jun 18:120671. doi: 10.1016/j.neuroimage.2024.120671. Online ahead of print. PMID:  38901774 The abstract is copied below: Background: Numerous studies show that electroconvulsive therapy (ECT) induces hippocampal neuroplasticity, but findings are inconsistent regarding its clinical relevance. This study aims to investigate ECT-induced plasticity of anterior and posterior hippocampi using mathematical complexity measures in neuroimaging, namely Higuchi's fractal dimension (HFD) for fMRI time series and the fractal dimension of cortical morphology (FD-CM). Furthermore, we explore the potential of these complexity measures to predict ECT treatme...

Out on PubMed,  as a preprint, is this paper: Electroconvulsive  Therapy Modulates Loudness Dependence of Auditory Evoked Potentials: A Pilot MEG Study. Dib M, Lewine JD, Abbott CC, Deng ZD. medRxiv [Preprint]. 2024 Apr 29:2024.04.26.24306462. doi: 10.1101/2024.04.26.24306462. PMID:  38903065   Free PMC article.   Preprint.   The abstract is copied below: Electroconvulsive therapy (ECT) remains a critical intervention for treatment-resistant depression (MDD), yet its neurobiological underpinnings are not fully understood. This pilot study utilizes high-resolution magnetoencephalography (MEG) in nine depressed patients receiving right unilateral ECT, to investigate the changes in loudness dependence of auditory evoked potentials (LDAEP), a proposed biomarker of serotonergic activity, following ECT. We hypothesized that ECT would reduce the LDAEP slope, reflecting enhanced serotonergic neurotransmission. Contrary to this, our findings indicated a significant ...

 Out on PubMed, Prevention of Oxygen Desaturation in a Patient With Previous Experience of Severe Hypoxia in Modified  Electroconvulsive  Therapy by Transnasal Humidified Rapid-Insufflation Ventilator Exchange: A Case Report. Toyota Y, Kondo T, Narasaki S, Miyoshi H, Tsutsumi YM. Cureus. 2024 May 18;16(5):e60564. doi: 10.7759/cureus.60564. eCollection 2024 May. PMID:  38887347   The abstract is copied below: Transnasal humidified rapid-insufflation ventilator exchange (THRIVE) has been reported to have better efficacy during anesthesia induction compared to conventional mask ventilation, including improved oxygenation and prolonged safe apnea time. This study reports on the effectiveness of the THRIVE system during modified electroconvulsive therapy (mECT) for a patient experiencing severe hypoxia. A 78-year-old female patient with bipolar disorder received maintenance mECT every four weeks. She previously experienced a significant hypoxic event, with oxygen sat...

 Out on PubMed, in JECT, from authors in the Czech Republic, is this case report: Electroconvulsive Therapy as an Effective and Safe Treatment in a Pregnant Patient With Thrombophilia and Epilepsy. Prídavka J, Hořínková J, Bartečková E. J ECT. 2024 Jun 20. doi: 10.1097/YCT.0000000000001023. Online ahead of print. PMID:  38924472   The LTE is here: This is very well presented case report; I am surprised that the "catatonic stupor" did not make it into the title. I had not heard of the term  "thrombophilia" for hypercoagulability, but am glad to be educated.  Kudos to our Czech colleagues for the good clinical management, with proper ECT technique, to insure a successful outcome.

 Out on PubMed, from authors in India, is this study: Dexmedetomidine for reducing succinylcholine-induced myalgia in patients undergoing  electroconvulsive  therapy: A randomised controlled trial. Sriramka B, Panigrahy S, Ramasubbu MK, Mishra SN. Indian J Anaesth. 2024 Jun;68(6):560-565. doi: 10.4103/ija.ija_1159_23. Epub 2024 May 8. PMID:  38903251 The abstract is copied below: Background and aim: Electroconvulsive therapy (ECT) is an effective intervention for psychiatric patients. Succinylcholine is considered the drug of choice for muscle relaxation for ECT. Significant adverse effects of succinylcholine include fasciculation and myalgia. Dexmedetomidine is a highly selective α-2 adrenergic agonist. This study aims to determine the efficacy of a low dose of dexmedetomidine in reducing succinylcholine-induced myalgia in patients receiving ECT. Methods: This randomised controlled trial was conducted on 100 patients, aged 18-65 years, undergoing ECT, who were rando...

Out on PubMed, from researchers in Boston and Nashville, is this paper: Exploring the Trajectory of Catatonia in Neurodiverse and Neurotypical Pediatric Hospitalizations: A Multicenter Longitudinal Analysis. Luccarelli J, Clauss JA, York T, Baldwin I, Vandekar S, McGonigle T, Fricchione G, Fuchs C, Smith JR. medRxiv [Preprint]. 2024 Jun 7:2024.06.06.24308554. doi: 10.1101/2024.06.06.24308554. PMID:  38883751   The abstract is copied below: Objective: Catatonia is a neuropsychiatric disorder that occurs in pediatric patients with a range of associated medical, psychiatric, and neurodevelopmental disorders (NDDs). This study describes hospital care of pediatric catatonia patients and compares treatments for neurotypical patients and those with NDDs. Methods: Retrospective cohort study from 1/1/2018 to 6/1/2023 of two academic medical centers of patients aged 18 and younger with catatonia. Patients were retrospectively assessed using the clinical global impressions-improvement (C...

 Out on PubMed, from authors in Turkey, is this article: The Effect of Electroconvulsive Therapy on Frontal QRS-T Angle in Psychiatric Patients. Fedai ÜA, Fedai H. Noro Psikiyatr Ars. 2024 May 29;61(2):135-140. doi: 10.29399/npa.28443. eCollection 2024. PMID:  38868850 The abstract is copied below: Introduction: Electroconvulsive therapy (ECT) is one of the biological therapies that is well tolerated and has a low risk of complications. Acute cardiovascular complications related to ECT such as ventricular arrhythmia, myocardial infarction and cardiac arrest have been recorded. Increased frontal QRS-T (fQRS-T) angle was associated with ventricular arrhythmia, sudden cardiac death and total mortality. In this study, we aimed to evaluate the effect of ECT on the myocardium using electrocardiography (ECG) parameters such as fQRS-T angle, QRS duration, QT and QTc interval. Methods: A total of 108 patients diagnosed with bipolar disorder (n=36), depressive disorder (n=70) and schizo...

 Out on PubMed, from authors in Brazil, is this review: Ketamine versus electroconvulsive therapy for major depressive episode: An updated systematic review and non-inferiority meta-analysis. Petrucci ABC, Fernandes JVA, Reis IA, da Silva GHS, Recla BMF, de Mendonça JC, Pedro VCS, D'Assunção LEN, Valiengo LDCL. Psychiatry Res. 2024 May 31;339:115994. doi: 10.1016/j.psychres.2024.115994. Online ahead of print. PMID:  38865906   Review. The abstract is copied below: We conducted a systematic review and meta-analysis to investigate the comparative effectiveness of ketamine versus electroconvulsive therapy (ECT) for the treatment of major depressive episodes (MDEs). PubMed, EMBASE and Cochrane Library databases were systematically searched for randomized controlled trials (RCTs) comparing ketamine and ECT for MDE. The primary outcome was response rate, for which we prespecified a non-inferiority margin of -0.1, based on the largest and most recent RCT. Response was defined as...

 Out on PubMed, from authors in Ohio, is this case series: Pharmacologic management of adolescent catatonia: A dual-case series. Leiby L, Shiplett L, Lin W, Dick M, Thornton H. Ment Health Clin. 2024 Jun 3;14(3):215-219. doi: 10.9740/mhc.2024.06.215. eCollection 2024 Jun. PMID:  38835818 The abstract is copied below: Introduction: Catatonia is a syndrome characterized by psychomotor and behavioral disturbances and is associated with a substantially increased mortality risk in adolescent patients. There is a dearth of published literature describing treatment strategies for pediatric patients with catatonia. This dual-case series will describe the treatment course of 2 adolescent patients with catatonia at our pediatric inpatient psychiatric facility. Case series: This case series presents 2 adolescent patients (a 17-year-old male and a 16-year-old female) who initially presented with worsening agitation and paranoia, later developing catatonia. Both patients required long dura...

 Out on PubMed, from authors in Pakistan and Ukraine, is this editorial: Addressing the stigma and promoting awareness:  Electroconvulsive  therapy in Pakistan. Ghori ETR, Zuberi MAW, Dave T, Shaikh VF. Health Sci Rep. 2024 Jun 11;7(6):e2197. doi: 10.1002/hsr2.2197. eCollection 2024 Jun. PMID:  38863731   The report is here . And here: It is good to hear from colleagues in Pakistan. They argue the position that ECT is critical but grossly underused, and under resourced, in their country. It is a difficult situation, indeed. My only other comment is that their message would have even more impact if their references were updated.