Psychiatric, Motor, and Autonomic Effects of Bifrontal ECT in Depressed Parkinson’s Disease Patients
| Autor: | Harpreet Chauhan, Nicholas J. Ainsworth, Je Hun Sung, Silke Appel-Cresswell, Isaac Rodin, Fidel Vila-Rodriguez, Kevin Smith |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Parkinson's disease medicine.medical_treatment Disease behavioral disciplines and activities Motor symptoms Electroconvulsive therapy mental disorders medicine Humans Electroconvulsive Therapy Depressive symptoms Depression (differential diagnoses) Aged Retrospective Studies Psychiatric Status Rating Scales Depressive Disorder Major British Columbia business.industry Parkinson Disease Middle Aged medicine.disease Autonomic Agents Frontal Lobe Psychiatry and Mental health Autonomic nervous system Female Neurology (clinical) business |
| Zdroj: | The Journal of Neuropsychiatry and Clinical Neurosciences. 33:161-166 |
| ISSN: | 1545-7222 0895-0172 |
| DOI: | 10.1176/appi.neuropsych.20050133 |
| Popis: | Depressive symptoms are a source of significant morbidity in Parkinson's disease (PD). Electroconvulsive therapy (ECT) is a promising treatment for depression in PD (dPD); however, data remain limited, including data on optimal electrode placement. In this retrospective study, the investigators aimed to characterize the effects of bifrontal ECT for dPD on psychiatric and motor symptoms, as well as autonomic response.Clinical data were retrieved from a university-affiliated ECT service in Vancouver, British Columbia, for patients with dPD receiving bifrontal ECT between 2014 and 2018. Clinical Global Impression (depressive symptoms) and Unified Parkinson's Disease Rating Scale (motor symptoms) scores and cardiovascular measurements during ECT, as well as doses of dopaminergic medications, were recorded.Eight patients met criteria for inclusion. Six patients (75%) met response criteria for improvement of depressive symptoms, including 83% of patients who completed a full ECT course. Five patients went on to receive maintenance ECT, with only one patient relapsing by the 1-year follow-up (20%). For patients with motor scales reported, 60% showed a clinically significant improvement in motor symptoms. Among patients who completed ECT, a reduction in the median dopaminergic medication dose was also observed (-350 mg). Two patients discontinued ECT as a result of tolerability concerns. Participants demonstrated a relatively typical pattern of autonomic response to ECT, with low incidence of bradycardic events.The results provide preliminary evidence of the benefit of bifrontal ECT in dPD for both depressive and motor symptoms. The autonomic data suggest that most patients with dPD respond in a typical physiological manner to ECT stimulus; however, further investigation is needed. |
| Databáze: | OpenAIRE |
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