Electroconvulsive Therapy

Khan, Arifulla; Mirolo, M. H.; Hughes, Deborah; Bierut, Laura J.

doi:10.1016/s0193-953x(18)30162-x

Cited by 34 publications

(20 citation statements)

References 81 publications

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“…Thus, to produce equal effects with ECT, massive stimulation, which invariably induced seizures, is required. This is consistent with the observation that the induction of seizures seems to be essential for the antidepressant effects of ECT but not rTMS (5,16,40). In this context, activation of the PVT and SCN by rTMS is especially interesting; PVT neurons receive synaptic input from the retina, which plays a central role in circadian rhythm regulation, and project to the SCN, where the master circadian clock is located (24,25,41).…”

Section: Discussionsupporting

confidence: 88%

“…The intensity of stimulation usually used in patients induces a self-sustained after-discharge of cortical neurons, which produces convulsive seizure. Therefore, ECT requires general anesthesia, induces massive autonomic stimulation, and can produce transient memory loss (16). The similar therapeutic effects of rTMS and ECT suggests the following hypothesis: current elicited in brain by electromagnetic induction (rTMS) and current induced by direct application of voltage, such as during ECT, produce overlapping responses.…”

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confidence: 99%

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Repetitive transcranial magnetic stimulation activates specific regions in rat brain

Schläepfer

Aizenman

et al. 1998

Proc. Natl. Acad. Sci. U.S.A.

181

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Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive technique to induce electric currents in the brain. Although rTMS is being evaluated as a possible alternative to electroconvulsive therapy for the treatment of refractory depression, little is known about the pattern of activation induced in the brain by rTMS. We have compared immediate early gene expression in rat brain after rTMS and electroconvulsive stimulation, a well-established animal model for electroconvulsive therapy. Our result shows that rTMS applied in conditions effective in animal models of depression induces different patterns of immediate-early gene expression than does electroconvulsive stimulation. In particular, rTMS evokes strong neural responses in the paraventricular nucleus of the thalamus (PVT) and in other regions involved in the regulation of circadian rhythms. The response in PVT is independent of the orientation of the stimulation probe relative to the head. Part of this response is likely because of direct activation, as repetitive magnetic stimulation also activates PVT neurons in brain slices.

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Section: Discussionsupporting

confidence: 88%

mentioning

confidence: 99%

Repetitive transcranial magnetic stimulation activates specific regions in rat brain

Schläepfer

Aizenman

et al. 1998

Proc. Natl. Acad. Sci. U.S.A.

181

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“…Le risque d'ECT avec l'âge est en rapport avec les fractures ostéo-articulaires à cause d'une décalcifi-cation osseuse mais cela n'existe plus depuis l'utilisation de l'anesthésie et des produits de curarisation. De nos jours, les risques principaux sont les crises convulsives prolongées et les troubles cardiovasculaires [69]. Cattan et al [70] rapportent que le risque de complications cardiaques est plus élevé après 80 ans, comparé à des patients de moins de 80 ans.…”

Section: Discussionunclassified

“…Cependant, Burd et Kettl [71] rapportent que les patients âgés de moins de 72 ans font significativement plus d'asystolie au décours des séances d'ECT comparés aux patients de plus de 77 ans. Les complications cardiaques ne sont pas très fréquentes et restent majoritairement transitoires [69]. L'ECT peut être utilisée, mais avec précaution, chez des patients ayant eu une pathologie cardiaque récente et sévère (infarctus du myocarde, trouble du rythme appareillé par pacemaker ou défibrillateur) [71], un accident vasculaire cérébral ou une hypertension arté-rielle sévère [69,73].…”

Section: Discussionunclassified

Intérêt de l’électroconvulsivothérapie (ECT) chez les sujets âgés souffrant d’une pathologie démentielle : une revue de la littérature

Quentin

Voyer

Daniel

et al. 2010

NPG Neurologie - Psychiatrie - Gériatrie

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“…The observations described here could ultimately help to clarify the as yet undetermined pathophysiology of NMS. To the editor: Since 1938, when the use of electroconvulsive therapy (ECT) was fi rst described in the literature, ECT has played a pivotal role in the treatment of severe mania and depression, schizophrenia, and conditions such as suicidal drive and vegetative dysregulation [1]. Since the 1950s, when succinylcholine was introduced to modify convulsions to prevent severe muscle contractions during ECT, and, therefore, to prevent serious musculoskeletal complications, succinylcholine has remained the most commonly used muscle relaxant for reducing the intense muscle contractions associated with ECT-induced seizure activity [2].…”

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confidence: 99%

Anesthetic management of electroconvulsive therapy in a patient with a known history of neuroleptic malignant syndrome

et al. 2007

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tinued. With the discontinuation of the medications and with supportive therapy such as hydration, symptomatic control of temperature, and acid-base and fl uid balance, the clinical symptoms resolved almost completely within 10 days. With the resolution of NMS, anesthesia for ECT was requested.The fi rst and all the subsequent ECT procedures were performed in the post-anesthesia recovery room with equipment and drugs to treat MH immediately available. During the procedure, EEG was continuously monitored (Thymatron System IV; SOMATICS, Lake Bluff, IL, USA). Induction of anesthesia was accomplished with propofol (target concentration at 2-2.5 µg·ml −1 by target-controlled infusion [TCI]) and succinylcholine (60 mg), intravenously. Because an excess of propofol has anti-epileptic properties, the optimal concentration for ECT had been titrated by monitoring EEG in a couple of patients undergoing ECT. The patient was ventilated by face mask with oxygen. Then the ECT stimulus was applied, and it produced an ensuing seizure. The durations of the repetitive spikes in the EEG were continuously measured, and successful ECT was defi ned as that with repetitive epileptic spikes on the EEG lasting at least more than 15 s. Spontaneous respiration resumed within 5 min. The body temperature was measured on several occasions following ECT, at intervals of 3-4 h. We did not observe any changes in body temperature or serum potassium level, and consequently, MH did not result. She received ECT on four subsequent occasions without any complications, and was discharged 3 weeks after the last ECT.Although NMS and MH may result from totally different pathophysiologies [5,6,9], the possibility that individuals susceptible to developing NMS may be vulnerable to developing MH remains to be determined, because MH and NMS have some clinical features in common. However, thus far, limited information is available regarding the safety of the use of succinylcholine in a patient with a known history of NMS [10]. We have reported here a patient with a known history of NMS who underwent ECT under anesthesia with propofol and succinylcholine without any complications, and MH did not result. The observations described here could ultimately help to clarify the as yet undetermined pathophysiology of NMS.

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Electroconvulsive Therapy

Cited by 34 publications

References 81 publications

Repetitive transcranial magnetic stimulation activates specific regions in rat brain

Repetitive transcranial magnetic stimulation activates specific regions in rat brain

Intérêt de l’électroconvulsivothérapie (ECT) chez les sujets âgés souffrant d’une pathologie démentielle : une revue de la littérature

Anesthetic management of electroconvulsive therapy in a patient with a known history of neuroleptic malignant syndrome

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