Clinical Neuroscience of ECT (CNECT)

Dear Blog followers and readers, I will be on hiatus until sometime in mid-October. I hope you will continue to check the ECT literature on PubMed. And remember, all prior blog posts are archived here. I would also remind you to try out OpenEvidence with your specific questions about ECT. Thank you, CK  

Out on PubMed, from authors in Korea, is this book chapter: Electroconvulsive Therapy ( ECT ) in Major Depression: Oldies but Goodies. Yun JY, Kim YK. Adv Exp Med Biol. 2024;1456:187-196. doi: 10.1007/978-981-97-4402-2_10. PMID:  39261430   Review. The abstract is copied below: Electroconvulsive therapy is one of the useful treatment methods for symptom improvement and remission in patients with treatment-resistant depression. Considering the various clinical characteristics of patients experiencing depression, key indicators are extracted from structural brain magnetic resonance imaging, functional brain magnetic resonance imaging, and electroencephalography (EEG) data taken before treatment, and applied as explanatory variables in machine learning and network analysis. Studies that attempt to make reliable predictions about the degree of response to electroconvulsive treatment and the possibility of remission in patients with treatment-resistant depression are continuously b...

Out on PubMed, in JECT,  from clinicians in Indiana, is this LTE: Catatonia Optimized With  ECT  and Maintenance IV Lorazepam in a Rare Chromosomal Disorder. Smith AC, Degen HE, Reis DC, Conroy SK. J ECT. 2024 Sep 11. doi: 10.1097/YCT.0000000000001071. Online ahead of print. PMID:   39259225   The letter is here: Here is a very complex case of recurrent catatonia in a patient with a rare chromosomal deletion, lupus cerebritis and autism spectrum disorder. The treatment efforts border on heroic, and the reported results are gratifying. Kudos to these authors for sharing their clinical experience.

Out on PubMed, from authors in Uganda and Canada, is this review: The electro-convulsive therapy story of Africa, a systematic review. Abaatyo J, Kaggwa MM. Discov Ment Health. 2024 Sep 9;4(1):31. doi: 10.1007/s44192-024-00085-2. PMID:  39251508   Review The abstract is copied below: Over the years, the use of Electroconvulsive therapy (ECT) has gained increasing acceptance as a viable treatment for managing treatment-resistant mental health conditions, and it is known to deliver more rapid therapeutic benefits than most treatment modalities in psychiatry. However, the practice of ECT exhibits significant variability both within and between countries. T his review aimed to shed light on the status of ECT in the African context and its implications for mental health care in the region. In July 2023, databases (Ovid, PubMed, Web of Science, etc.) were searched for articles about ECT in Africa, following the PRISMA guidelines. Eligible studies reporting ECT practices in Africa a...

 Out on PubMed, from authors in germany, is this study: Electroconvulsive therapy in people with intellectual disability]. Guhra M, Kreisel SH, Zilles-Wegner D, Sartorius A, Sappok T, Freundlieb N. Nervenarzt. 2024 Aug 21. doi: 10.1007/s00115-024-01713-6. Online ahead of print. PMID:  39240313   Review.   German The abstract is copied below: Electroconvulsive therapy (ECT) is a highly effective treatment option for severe mental illness. Although people with intellectual disability (ID) have similar prevalence rates of mental disorders in comparison to the general population their access to ECT remains challenging. A systematic literature review was carried out on treatment with ECT in patients with ID and a case report on a patient with ID who underwent ECT is presented, to highlight a typical clinical routine. A total of 100 articles with 208 different case reports were retrieved. In summary, the results underline the effectiveness of ECT in people with ID, with si...

Out on PubMed, from authors in Ireland, in Acta Psychiatrica Scandinavica, is this paper: Childhood maltreatment and outcomes following electroconvulsive therapy in adults with depression. Jelovac A, Mohan C, Whooley E, Igoe A, McCaffrey C, McLoughlin DM. Acta Psychiatr Scand. 2024 Sep 5. doi: 10.1111/acps.13756. Online ahead of print. PMID:  39234974 The abstract is copied below: Objective: Childhood maltreatment is associated with less favourable treatment outcomes with pharmacotherapy and psychotherapy for depression. It is unknown whether this increased risk of treatment resistance in maltreated individuals extends to electroconvulsive therapy (ECT). Methods: This retrospective cohort study included 501 consecutive adult referrals for an acute course of twice-weekly ECT for unipolar or bipolar depression at an academic inpatient centre in Ireland between 2016 and 2024. Retrospectively reported physical and sexual childhood maltreatment were assessed on hospital admission . Resp...

 Out on PubMed, from clinicians in Denmark, is this case report: 15-year-old girl with bipolar affective disorder treated with ECT. Hoeck PR, Kessing LV, Pagsberg AK, Andersen MLM. Ugeskr Laeger. 2024 Aug 26;186(35):V02240137. doi: 10.61409/V02240137. PMID:  39234894   Danish The case report is here: Always good to have more evidence of the benefits of ECT in patients with bipolar disorder, in this case an adolescent. She had rapid improvement with ECT; the complications in the course were related to the concomitant medications. It would have been nice to have more details about the ECT treatments. Kudos to these authors for their contribution to the literature on the use of ECT for the treatment of mania.

Out on PubMed, from authors in Poland, is this review article: Around anesthesia: anesthetic aspects of electroconvulsive treatment in the light of the latest reports - review article. Rodek P, Mędrala W, Chrobak J, Barabasz-Gembczyk A, Alli-Balogun B, Kucia K. Psychiatr Pol. 2024 Feb 20:1-11. doi: 10.12740/PP/OnlineFirst/174768. Online ahead of print. PMID:  39217425   Review.   English, Polish. The abstract is copied below: Electroconvulsive therapy (ECT) remains the most effective method of treating acute mental conditions in psychiatry. The progress that has been made in anesthesiology in recent years allows for the personalization and optimization of electroconvulsive therapy through purely anesthetic interventions. There are few procedures in medicine where anesthesia would have such a direct impact on the effectiveness, or even success, of a given procedure. A key aspect of electroconvulsive therapy is a selection of the appropriate anesthetic. In Polish conditions...

 Out on PubMed, from clinicians in Florida, is this case report: Reducing Respiratory Complications During Electroconvulsive Therapy ( ECT ) With Smaller Doses of Succinylcholine in a Morbidly Obese Patient: A Case Report. Zhang RV, Carr BR. Cureus. 2024 Jul 29;16(7):e65654. doi: 10.7759/cureus.65654. eCollection 2024 Jul. PMID:  39205780 The abstract is copied below: Anesthesia for electroconvulsive therapy (ECT) requires proper medications and airway management. Besides an induction agent such as methohexital, a neuromuscular blocker such as succinylcholine (SCh) is often given for muscle relaxation. To maintain the patient's oxygen saturation, mask ventilation is required due to this transient chemical paralysis even in the presence of adequate preoxygenation. A morbidly obese, middle-aged female experienced multiple life-threatening hypoxic episodes due to "bronchospasms" during prior ECT treatments. A drastic reduction in the SCh dose to about half of the original do...

 Out on PubMed, from researchers in Mexico, is this study: Neurological Damage Measured by S-100b and Neuron-Specific Enolase in Patients Treated with Electroconvulsive Therapy. Ruiz-Chow ÁA, López-Cruz CJ, Crail-Meléndez D, Ramírez-Bermúdez J, Santos-Zambrano J, Luz-Escamilla LA. Brain Sci. 2024 Aug 16;14(8):822. doi: 10.3390/brainsci14080822. PMID:  39199513 The abstract is copied below: Electroconvulsive therapy (ECT) is considered one of the most effective treatments for psychiatric disorders. ECT has proven effective in the treatment of depression, mania, catatonia and psychosis. It is presumed that seizures induced during ECT administration cause toxicity and potentially neuronal and glial cell death. A broad range of neurological disorders increase cerebrospinal fluid and serum levels of neuron-specific enolase (NSE) and S-100b protein. This study aims to investigate the effect of ECT on NSE and S-100b levels, which, together, serve as a proxy for neuronal cell damage. ...

Out on PubMed, from authors in Australia, is this paper:  Pharmacotherapy and electroconvulsive therapy prescription for women with depressive and anxiety disorders in a psychiatric mother-baby unit. Saluja S, Cooter A, Roberts S, Branjerdporn G. Australas Psychiatry. 2024 Aug 29:10398562241278856. doi: 10.1177/10398562241278856. Online ahead of print. PMID:  39209800 The abstract is copied below: Objective: T he purpose of this study was to understand the pharmacotherapy and electroconvulsive therapy (ECT) prescription of women with depression and anxiety admitted to an Australian inpatient psychiatric mother-baby unit (MBU) and compare prescription to national clinical practice guidelines. Method: A retrospective audit was conducted on women diagnosed with depression or anxiety admitted to a public psychiatric inpatient MBU from March 2017 to July 2019. Data was captured at three time points to assess demographic, clinical and pharmacotherapy treatment characteristics. Descr...

  The aim of this post is to bring the site, OpenEvidence, to your attention. This is what they say about themselves: Based on a few test questions about ECT. I am very impressed, so far. Blog reader/follower comments would be most appreciated, thanks!