Low-Charge Electrotherapy in Geriatric Major Depressive Disorder Patients: A Case Series
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
To examine the feasibility of low-charge electrotherapy (LCE) in treating geriatric major depressive disorder (MDD) patients. Bi-temporal LCEs (approximately 25 mC) were performed with an electroconvulsive therapy (ECT) instrument three times per week. We used the Hamilton Depression Scale 17 (HAMD-17) and the Hamilton Anxiety Scale (HAMA) to assess the effects of LCE and the Mini- Mental State Examination (MMSE) to evaluate the cognitive function change before and after LCE. Six visits occurred at the baseline, after LCE sessions 3, 6, and 9, after the last session, and at the end of the one-month follow-up period. Four patients were enrolled in the study. Two patients completed all LCE sessions. Two patients withdrew during the trial, one due to the adverse event of uroschesis potentially caused by atropine and the other due to her own will. All four patients completed the follow-up sessions. The HAMD-17 and HAMA scores were reduced significantly at the last LCE session and the end of the follow-up period compared with the scores at the baseline. As measured by the MMSE, cognitive impairment showed no significant changes at the last LCE session and the end of the follow- up period compared with that at the baseline. In this case series, LCE showed potential as an alternative current-based treatment for treating geriatric MDD patients. Further research is needed to assess the efficiency and safety of LCE.
Abstract
To examine the feasibility of low-charge electrotherapy (LCE) in treating geriatric major depressive disorder (MDD) patients. Bi-temporal LCEs (approximately 25 mC) were performed with an electroconvulsive therapy (ECT) instrument three times per week. We used the Hamilton Depression Scale 17 (HAMD-17) and the Hamilton Anxiety Scale (HAMA) to assess the effects of LCE and the Mini- Mental State Examination (MMSE) to evaluate the cognitive function change before and after LCE. Six visits occurred at the baseline, after LCE sessions 3, 6, and 9, after the last session, and at the end of the one-month follow-up period. Four patients were enrolled in the study. Two patients completed all LCE sessions. Two patients withdrew during the trial, one due to the adverse event of uroschesis potentially caused by atropine and the other due to her own will. All four patients completed the follow-up sessions. The HAMD-17 and HAMA scores were reduced significantly at the last LCE session and the end of the follow-up period compared with the scores at the baseline. As measured by the MMSE, cognitive impairment showed no significant changes at the last LCE session and the end of the follow- up period compared with that at the baseline. In this case series, LCE showed potential as an alternative current-based treatment for treating geriatric MDD patients. Further research is needed to assess the efficiency and safety of LCE.
참고문헌 (20)
- Cusin C, "Somatic therapies for treatment-resistant depression : ECT, TMS, VNS, DBS", Biol Mood Anxiety Disord, 2, pp.14~ (2012)
- Kerner N, "Current electroconvulsive therapy practice and research in the geriatric population", Neuropsychiatry(London), 4, pp.33~54 (2014)
- Hausner L, "Efficacy and Cognitive Side Effects of Electroconvulsive Therapy(ECT)in Depressed Elderly Inpatients With Coexisting Mild Cognitive Impairment or Dementia", J Clin Psychiatry, 72, pp.91~97 (2011)
- McCall WV, "Pretreatment differences in specific symptoms and quality of life among depressed inpatients who do and do not receive electroconvulsive therapy : a hypothesis regarding why the elderly are more likely to receive ECT", J ECT, 15, pp.193~201 (1999)
- Loo CK, "Transcranial direct current stimulation for depression : 3-week, randomised, sham-controlled trial", Br J Psychiatry, 200, pp.52~59 (2012)
- Hansen PEB, "Low-frequency repetitive transcranial magnetic stimulation inferior to electroconvulsive therapy in treating depression", J ECT, 27, pp.26~32 (2011)
- Chen JJ, "Comparative efficacy and acceptability of electroconvulsive therapy versus repetitive transcranial magnetic stimulation for major depression : a systematic review and multiple-treatments meta-analysis", Behav Brain Res, 320, pp.30~36 (2017)
- Ren JJ, "Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression : A systematic review and meta-analysis", Prog Neuropsychopharmacol Biol Psychiatry, 51, pp.181~189 (2014)
- Alexander L, "Nonconvulsive electric stimulation therapy; its place in the treatment of affective disorders, with notes on the reciprocal relationship of anxiety and depression", Am J Psychiatry, 107, pp.241~250 (1950)
- Beran M, "Psychological studies on patients undergoing nonconvulsive electric-stimulation treatment", Am J Psychiatry, 109, pp.367~374 (1952)
- Olkon DM, "Subconvulsive electrotherapy in mental disorders", Dis Nerv Syst, 18, pp.271~ (1957)
- Prudic J, "Acute cognitive effects of subconvulsive electrical stimulation", Convuls Ther, 10, pp.4~24 (1994)
- Regenold WT, "Nonconvulsive electrotherapy for treatment resistant unipolar and bipolar major depressive disorder : a proof-of-concept trial", Brain Stimul, 8, pp.855~861 (2015)
- Kong XM, "Electroconvulsive therapy changes the regional resting state function measured by regional homogeneity(ReHo)and amplitude of low frequency fluctuations(ALFF)in elderly major depressive disorder patients : an exploratory study", Psychiatry Res Neuroimaging, 264, pp.13~21 (2017)
- Sackeim HA, "Is the seizure an unnecessary component of electroconvulsive therapy? A startling possibility", Brain Stimul, 8, pp.851~854 (2015)
- Dybedal GS, "The role of baseline cognitive function in the neurocognitive effects of electroconvulsive therapy in depressed elderly patients", Clin Neuropsychol, 29, pp.487~508 (2015)
- Semkovska M, "Objective cognitive performance associated with electroconvulsive therapy for depression : a systematic review and meta-analysis", Biol Psychiatry, 68, pp.568~577 (2010)
- Bodnar A, "Electroconvulsive therapy and cognitive functions in treatment-resistant depression", World J Biol Psychiatry, 17, pp.159~164 (2016)
- Sinclair JE, "Assessing the association between electrical stimulation dose, subsequent cognitive function and depression severity in patients receiving bilateral electroconvulsive therapy for major depressive disorder", J ECT, 32, pp.159~163 (2016)
- Martin DM, "A new early cognitive screening measure to detect cognitive side-effects of electroconvulsive therapy?", J Psychiatr Res, 47, pp.1967~1974 (2013)