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【Objective】 To explore the action mechanism of vinpocetine in improving learning and memory disorders in depressive rats after modified electroconvulsive therapy (MECT). 【Methods】 The models of depressive rats were constructed by chronic unpredictable mild stress (CUMS) method. A total of 30 rats with depression were randomly divided into depression group, MECT group, and MECT+vinpocetine (10 mg/kg) group, with 10 in each group. A total of 10 untreated healthy rats were enrolled as control group. The learning and memory ability were tested by Morris water maze test and novel object recognition test. The depression state was evaluated by sugar preference test. The brain slices of the hippocampus were prepared for electrophysiological experiments. The density of dendritic spine was detected by Golgi staining. The expressions of endocannabinoids related genes [diacylglycerol lipase (DAGLα), monoacylglycerol lipase (MAGL), and endocannabinoid type-I receptor (CB1R)] were detected by qPCR and Western blotting. The lentivirus was injected to downregulate the expressions of CB1R and DAGLα in the hippocampus. After re-modeling and treatment, behavioral tests were performed. 【Results】 Compared with control group, sugar preference, spatial exploration time, relative discrimination index, long-term potentiation (LTP), density of dendritic spine, expressions of DAGLα and CB1R were decreased, while escape latency and MAGL were increased in depression group (P<0.05). Compared with depression group, sugar preference, escape latency, and MAGL were increased, while spatial exploration time, relative discrimination index, LTP, density of dendritic spine, expressions of DAGLα and CB1R were decreased in MECT group (P<0.05). Compared with depression group, sugar preference, spatial exploration time, relative discrimination index, LTP, density of dendritic spine, expressions of DAGLα and CB1R were increased, while escape latency and MAGL were decreased in MECT+vinpocetine group (P<0.05). Compared with MECT group, sugar preference, spatial exploration time, relative discrimination index, LTP, density of dendritic spine, expressions of DAGLα and CB1R were increased, while escape latency and MAGL were decreased in MECT+vinpocetine group (P<0.05). The down-regulation of DAGLα or CB1R by lentivirus could inhibit the improvement effect of vinpocetine on behavioral performance of depressive rats after MECT. 【Conclusion】 Vinpocetine can significantly improve learning and memory disorders in depressive rats after MECT, which may be related to regulating the expressions of endocannabinoid-related genes and enhancing synaptic plasticity.
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Objective:To investigate the efficacy of maintenance electroconvulsive therapy (MECT) combined with quetiapine treatment for manic episodes of bipolar disorder.Methods:A total of 103 patients with manic episodes of bipolar disorder received treatment in Kangci Hospital of Jiaxing from January 2019 to August 2020 and were included in this study. They were randomly divided into observation ( n = 46) and control groups ( n = 57). The observation group was given MECT combined with quetiapine treatment and the control group was treated with magnesium valproate sustained-release tablets combined with quetiapine. All patients received 4 weeks of treatment. Clinical efficacy, total hospital cost, drug cost during hospitalization, drug proportion, adverse reactions, and scores of the Bech-Rafaelsdn Mania Rating Scale and the Wisconsin Card Sorting Test pre- and post-treatment were compared between the two groups. Results:After 4 weeks of treatment, total response rate was significantly higher in the observation group than in the control group [76.09% (35/46) vs. 56.14% (32/57), χ2 = 4.45, P < 0.05]. In the observation group, total hospital cost, drug cost during hospitalization, and drug proportion were (16074.52 ± 1019.81) yuan, (1374.52 ± 619.81) yuan, and 8.70% respectively, which were not significantly different from those in the control group [(15618.14 ± 1550.34) yuan, (1261.14 ± 750.34) yuan, 10.53%, t = 1.71, 0.82, χ2 = 0.09, all P > 0.05]. After 4 weeks of treatment, Bech-Rafaelsdn Mania Rating score was significantly lower in the observation group than in the control group [(7.36 ± 3.04) points vs. (10.23 ± 2.37) points, t = 5.38, P < 0.001]. The number of wrong responses and the number of perseverative errors in the Wisconsin Card Sorting Test in the observation group were (40.45 ± 3.61) counts and (9.56 ± 1.39) counts, respectively, which were significantly lower than those in the control group [(48.59 ± 4.51) counts, (12.08 ± 1.25) counts, t = 10.17, 9.56, both P < 0.001]. The number of perseverative errors in the Wisconsin Card Sorting Test was significantly higher in the observation group than in the control group [(33.85 ± 2.50) counts vs. (29.71 ± 2.14) counts, t = 8.90, P < 0.001]. There was no significant difference in total incidence of adverse reactions between observation and control groups (21.74% vs. 22.81%, χ2 = 0.01, P > 0.05). Conclusion:MECT combined with quetiapine treatment is highly effective on the manic episodes of bipolar disorder. The combined therapy is worthy of clinical application.
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ObjectiveTo observe the intervention effect of cluster nursing in post-MECT delirium，and explore a new method of post-MECT delirium nursing. MethodsA total of 154 inpatients who met the diagnostic criteria of International Classification of Diseases，tenth edition（ICD-10） and received MECT treatment for the first time were selected and they were randomly divided into control group （n = 77） and study group （n = 77）. The intervention lasted for one course of MECT， 6-12 times MECT as one course. Both groups recieved MECT routine nursing， while the study group was given cluster nursing on the basis of routine nursing. After each treatment， Richmond Agitation Sedation Scale （RASS） and nursing adverse events record form were used to collect data. The incidence and duration of post-MECT delirium and the incidence of nursing adverse events caused by post-MECT delirium were compared between the two groups. ResultsAfter one course of MECT， the incidence of post-MECT delirium was 11.80% in the study group and 16.67% in the control group， the difference was statistically significant （χ2= 6.314， P<0.05）. The duration of post-MECT delirium in the study group was（5.78±2.73）min and（11.20±4.44）min in the control group， the difference was statistically significant （t=3.403， P<0.05）. The incidence of nursing adverse events caused by post-MECT delirium was 7.13% in the study group and 12.70% in the control group， and the difference was statistically significant （χ2=10.940， P<0.01）. ConclusionThe implementation of cluster nursing can reduce the incidence of post-MECT delirium， shorten the duration and reduce the nursing adverse events caused by post-MECT delirium.
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The report elaborated a case of a 52-year-old female patients with over 10 years of schizophrenia complicating 12 months of stupor. After a course of modified electroconvulsive therapy（MECT） combined with risperidone oral solution， the patient gradually became active and functionally recovered， and remained stable. This case suggests that MECT combined with risperidone may allow schizophrenia patients in a state of prolonged stupor to obtain clinical rehabilitation and effectively stabilize psychotic symptoms. The discussion is based on this case with a view to providing references for clinical treatment.
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Modified electroconvulsive therapy (MECT) is a fast and effective physical therapy method currently widely used in psychiatry. The anesthesia target of this treatment is to calm the patients, relax the muscles and maintain stability in histodynamics during treatment, meanwhile avoiding affecting efficacy, because too deep anesthesia can inhibit discharge of the cerebral cortex. However, current anesthetic drugs in MECT, including muscle relaxants, intravenous anaesthetics, inhalation anaesthetics, analgesics, etc., lack the best compatibility of anesthesia induction. This review discusses the application and compatibility of these drugs in MECT in recent years, in order to provide reference for the best anesthesia induction protocol for MECT.
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Objective To observe the effect of modified electroconvulsive therapy (MECT) on au-tobiographical memory and efficacy in schizophrenic patients. Methods Seventy-four patients with schizo-phrenia were randomly divided into study group (38 cases) and control group (36 cases). The study group was treated with MECT for 10-12 times in combination with single antipsychotic drug,while the control group was treated with single antipsychotic drug. Both groups were treated for 12 weeks. All patients were assessed for autobiographical memory before treatment and at the 4th,8th and 12th week after treatment,and the effi-cacy was evaluated by the positive and negative symptom scale (PANSS). Results (1)The response time of autobiographical event memory in the study group at the 4th and 8th weekends after treatment ((2 058. 84 ±200. 06)ms,(1 883. 61±202. 17)ms)were significantly longer those at baseline((1 765. 27±203. 23)ms) and that at the same periods in the control group(( 1 787. 03 ± 192. 82),(1 762. 01± 195. 25)),and the differences were statistically significant(t=6. 346,2. 545;P<0. 05,t=5. 945,2. 630;P<0. 05),but the re-sponse time of autobiographical event memory in the study group at the 12th weekend after treatment was not statistically significant compared with that before treatment (P>0. 05). ( 2) For each time point after treat-ment,the PANSS scores of the study group and the control group were significantly lower than those at base-line (P<0. 05). The PANSS scores of the study group at each time point after treatment((62. 42±7. 22), (49. 32±5. 54),(43. 63±9. 90)) were significantly lower than those of the control group at the same periods ((71. 78±10. 19),(56. 14±5. 95),(49. 28±9. 31)),and the differences were statistically significant ( t=4. 577,5. 108,2. 525;all P<0. 05). The total effective rate of the study group ( 94. 7%) was significantly higher than that of the control group (80. 6%) (χ2=9. 287,P<0. 05). Conclusions MECT is effective in the treatment of patients with schizophrenia,and it has some damage to their autobiographical memory,but the damage is transient and reversible.
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Objective To explore nursing safety management path of patients treat with modified electroconvulsive therapy(MECT) to improve the quality of nursing and reduce the adverse events. Methods According to the theory of Hazard Analysis and Critical Control Point(HACCP)and the SBAR standard communicative model, design and apply nurses handover check list for patients who treat with MECT(the following are referred to as MECT form).The nurses used MECT form to evaluate and manage the risk of patients before and after MECT treatment. This was also help to control the standardization criterion of nursing before and after treatment,meanwhile reduce the risk of treatment.Analyze the data of adverse event before and after applied this MECT form. Results After applied this form for one year,the number of above levle-0 adverse events decreased from 3.51% (191/5 441) to 1.05% (61/5 817) (x2=77.856, P 0.05). Conclusion The application of MECT form improves the nursing quality of MECT treatment in psychiatric department and secure the nursing safety.
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Objective To observe the effects of three doses of dexmedetomidine hydrochloride on stress and myalgia in patients before conventional modified electroconvulsive therapy (MECT).Methods Seventy-nine patients scheduled for the first time of MECT with schizophrenia,depression or mania patients,38 males and 41 females,aged 18-65 years,ASA physical status Ⅰ or Ⅱ,were randomly divided into four groups.The patients received intravenous drip infusion of dexmedetomidine 0.4 μg/kg (group D1,n=20),0.7μg/kg (group D2,n=19),1.0 μg/kg (group D3,n=20) and saline 20 ml (group N,n =20) within 10 min before conventional MECT treatment.The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia (T0),drug pump (dexmedetomidine or saline) after 10 min (T1),30 s after MECT shock (T2) and 5 min after MECT shock (T3);the blood glucose and the concentration of serum cortisol (Cor) were recorded at T0 and T2;visual analogue scores (VAS) 30 min after electric shock (T1) and 6 h after shock (T5),the recovery time,recovery time of spontaneous breathing were also recorded.Results Compared with group N,the concentration of Cor and MAP at T2 were decreased significantly,the HR was increased significantly in groups D1-D3;the blood glucose at T2 were decreased significantly in groups D2,D3 (P＜0.05).The degree in group D3 was larger than that in group D2,and the degree in group D2 was larger than that in group D1 (P＜0.05).Compared with group N,the VAS score at T5 were decreased significantly in groups D1-D3;the recovery time was prolonged significantly in groups D2,D3.The degree in group D3 was larger than that in group D2,and the degree in group D2 was larger than that in group D1 (P＜0.05).The spontaneous breathing recovery time had no difference in three groups.Conclusion Dexmedetomidine pretreatment before modified electroconvulsive therapy can dose-dependently reduce stress response and treatment related myalgia and prolong the recovery time.
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Modified electroconvulsive therapy (MECT) and magnetic seizure therapy (MST) are effective treatments for severe major depression. MECT has better efficacy in the treatment than MST, but it has cognitive and memorial side effects while MST does not. To study the causes of these different outcomes, this study contrasted the electric filed strength and spatial distribution induced by MECT and MST in a realistic human head model. Electric field strength induced by MECT and MST are simulated by the finite element method, which was based on a realistic human head model obtained by magnetic resonance imaging. The electrode configuration of MECT is standard bifrontal stimulation configuration, and the coil configuration of MST is circular. Maps of the ratio of the electric field strength to neural activation threshold are obtained to evaluate the stimulation strength and stimulation focality in brain regions. The stimulation strength induced by MECT is stronger than MST, and the activated region is wider. MECT stimulation strength in gray matter is 17.817 times of that by MST, and MECT stimulation strength in white matter is 23.312 times of that by MST. As well, MECT stimulation strength in hippocampi is 35.162 times of that by MST. More than 99.999% of the brain volume is stimulated at suprathreshold by MECT. However, MST activated only 0.700% of the brain volume. The stimulation strength induced by MECT is stronger than MST, and the activated region is wider may be the reason that MECT has better effectiveness. Nevertheless, the stronger stimulation strength in hippocampi induced by MECT may be the reason that MECT is more likely to give rise to side effects. Based on the results of this study, it is expected that a more accurate clinical quantitative treatment scheme should be studied in the future.
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Objective · To investigate the effect of modified electroconvulsive therapy (MECT) on oxidative stress parameters in patients with bipolar disorder. Methods · Forty-three patients with bipolar disorder (case group) were enrolled that received MECT intervention for 6 weeks, and 49 healthy volunteers (control group) were recruited. Chinese versions of the 17 items Hamilton Depression Rating Scale (HAMD-17), Young Mania Rating Scale (YMRS) and Clinical Global Impression-Severity Scale (CGI-S) were used to assess the efficacy and side effects at baseline and after 6 weeks of treatment. The plasma levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) were measured at baseline and after 6 weeks of treatment to assess the level of oxidative stress. Results · The serum MDA and GSH-Px levels of the case group were higher while the serum SOD levels of the case group was lower than that of the control group, and there was no significant difference in the serum CAT levels between two groups at baseline. MDA levels were higher in manic states than in depressed states, and they were positively correlated with the CGI-S scores. After MECT treatment, the CGI-S scores of patients decreased significantly, and the plasma MDA levels decreased significantly in manic and depressive states, but there was no change in other oxidative stress parameters. Conclusion · There was oxidative stress damage in patients with bipolar disorder, and the severity of the disease varied with the degree of damage. MECT improved the symptoms of the disease and decreased the level of plasma MDA, while there was no effect on the anti-oxidation index.
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The treatment of mental disorders during pregnancy is challenging.Modified electroconvulsive therapy (MECT) has become one of the important and powerful treatment methods,which is safe with a rapid onset of action and fewer side effects,benefiting for patients in acute stage especially for those with suicidal ideation.This article mainly discusses the superiority of MECT in the treatment of mental disorders in pregnancy,as well as the treatment principle in women and fetus.Through pretreatment evaluation and closely monitoring of therapeutic efficacy during and after treatment,the complications of pregnant women and fetuses,such as vaginal bleeding,premature labor and fetal arrhythmia,can be effectively minimized.Taken together,MECT seems to be a safe and effective measure in treating mental disorders during pregnancy.
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Objective To investigate the efficacy and side effects of aripiprazole combined with modified electroconvulsive therapy (MECT) in the treatment of female refractory schizophrenia.Methods One hundred and five female refractory schizophrenia patients in the Second Affiliated Hospital of Xinxiang Medical University from July 2014 to May 2016 were selected and divided into control group and observation group.Fifty-two patients in the control group were treated with aripiprazole.In the observation group,53 patients were treated with aripiprazole combined with MECT.All the patients were treated for eight weeks.Clinical efficacies were assessed with the positive and negative syndrome syndrome scale (PANSS);Wechsler memory scale (WMS) were used to evaluate the effect of MECT on memory.Adverse drug reactions were evaluated by treatment emergent symptom scale(TESS) before and after treatment in both groups.Results There was no significant difference in PANSS scores between the two groups before treatment (P ＞ 0.05).The positive symptom scores,the general mental pathology scores and the PANSS total scores in the two groups at the end of the second week were significantly lower than before treatment(P ＜ 0.05);at the end of fourth and eighth week of treatment,the negative symptom scores,the positive symptom scores,the general psychopathological scores and the PANSS total scores of the two groups were significantly lower than those before treatment (P ＜ 0.05 or P ＜ 0.01).The positive symptoms,the general psychopathological scores and the PANSS total score in the observation group were significantly lower than those in the control group at the end of fourth week of treatment (P ＜0.05).At the end of the eighth week of treatment,the negative symptom scores,the positive symptom scores,the general psychopathological scores and the PANSS total scores in the observation group were significant lower than those in the control group (P ＜ 0.05).At the end of the eighth week of treatment,the decreasing rates of PANSS score in the observation group and control group were (39.89-8.62) ％ and (31.97-± 8.17) ％,and the total effective rates were 66.67％ and 48.08％,respectively.The decreasing rates of PANSS score and total effective rates in the observation group were higher than those in the control group (P ＜ 0.05).The WMS score of the observation group decreased more significantly at the end of the second week of treatment compared with that before treatment;at the end of the fourth week of treatment,the score of the picture was louer than that before treatment(P ＜ O.05);but there was no significant difference in WMS score between that at the end of the eighth week and before treatment(P ＞ 0.05).There was no significant difference between the two groups in the TESS score and adverse reaction rate (P ＞ 0.05).Conclusion Compared with single application of aripiprazole,MECT combined with aripiprazole can significantly improve effects in treating female refractory schizophrenia and it can not increase the side effects.
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Objective · To explore the correlation of serum S100B protein with depressive episode of bipolar disorder (BD) and its prognosis.Methods· Based on BD criteria of Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-Ⅳ),80 patients with depressive episode of BD (case group) and 42 healthy controls (control group) were enrolled.Patients were randomly assigned into quetiapine group who were treated with lithium and quetiapine and modified electroconvulsive therapy (MECT) group who received lithium and MECT.The serum S100B level and Hamilton Rating Scale for Depression (HAMD) were assayed before and after 4-week treatment.Results· The serum S100B levels before treatment in patients with depressive episode of BD were significantly higher than those in healthy controls (P=0.000).The levels of S100B in both drug and MECT groups decreased after 4-week treatment.The HAMD score after treatment significantly decreased than that before treatment (P=0.000).Pearson correlation analysis showed that the change of S 100B level was positively correlated with the change of HAMD score before and after treatment in case group (r=0.33,P=0.013).Conclusion· S100B may be associated with depressive episode of BD and its prognosis.
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Objective · To investigate the effect of modified electroconvulsive therapy (MECT) on oxidative stress parameters in patients with bipolar disorder. Methods · Forty-three patients with bipolar disorder (case group) were enrolled that received MECT intervention for 6 weeks, and 49 healthy volunteers (control group) were recruited. Chinese versions of the 17 items Hamilton Depression Rating Scale (HAMD-17), Young Mania Rating Scale (YMRS) and Clinical Global Impression-Severity Scale (CGI-S) were used to assess the efficacy and side effects at baseline and after 6 weeks of treatment. The plasma levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) were measured at baseline and after 6 weeks of treatment to assess the level of oxidative stress. Results · The serum MDA and GSH-Px levels of the case group were higher while the serum SOD levels of the case group was lower than that of the control group, and there was no significant difference in the serum CAT levels between two groups at baseline. MDA levels were higher in manic states than in depressed states, and they were positively correlated with the CGI-S scores. After MECT treatment, the CGI-S scores of patients decreased significantly, and the plasma MDA levels decreased significantly in manic and depressive states, but there was no change in other oxidative stress parameters. Conclusion · There was oxidative stress damage in patients with bipolar disorder, and the severity of the disease varied with the degree of damage. MECT improved the symptoms of the disease and decreased the level of plasma MDA, while there was no effect on the anti-oxidation index.
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Objective To evaluate the antidepressant efficacy and adverse reactions of 3 different stimulus dosage of modified electroconvulsive therapy ( MECT) in patients with depressive episode. Methods 120 patients with depressive episode were randomized into low dosage group ( n=40) ,medium dosage group ( n=40) and high dosage group ( n=40) . Low dosage were 50%× age,medium dosage was 70%×age,high dosage was 80%×age . All patients received 6 treatments. Hamilton depression scale?17(HAMD?17) was used to evaluate the clinical symptoms at baseline,3 and 6 treatments. Effects and adverse reactions were compared among three groups.Results Compared with baseline the HAMD?17 scores of the 3 groups were significantly improved after 6 treatments( t=24.026, P=0.000;t=26.541, P=0.000;t=25.904, P=0.000) , but there were no statistically significant differences among the three dosage groups(F=0.409, P=0.665). Compared with low dosage group((27.2±5.4)%),the HAMD?17 scores reductive ratio of medium dosage group((34.3±6.8)%) and high dosage group((33.9±6.9)%)) were significantly improved after 3 treat?ments ( t=-5.513, P=0.000;t=-4.785, P=0.000). Compared with the low dosage group,the incidence rate of headache,nausea and vomiting,delirium were significantly higher in high dosage groups( headache:χ2=14.532, P=0.000;nausea and vomiting:χ2=13.333, P=0.000;delirium:χ2=14.907, P=0.000) . The re?covery time was significantly longer in medium dosage group ( ( 10. 5 ± 1. 6 ) min ) and high dosage group ((11.2±1.8)min) than that in low dosage group((8.8±1.2)min)( t=-5.144,=0.000;t=-6.889, P=0.000).Conclusion Different stimulus dosage of MECT for depressive episode has equivalent curative effect after 6 treatment . Medium dosage and high dosage treatments appear to have an early onset of efficacy,but may also be associated with more adverse reactions.
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Objective To examine the effect of modified electroconvulsive therapy (MECT) on the plasma oxida-tive stress level in bipolar depression. Methods Forty-two patients with bipolar depression were randomly divided into two groups. The intervention group (n=18) received antidepressants and 12 times MECT for 6 weeks and the control group (n=24) received antidepressants and Li2CO3 for 6 weeks. The Chinese versions of the 17 items Hamilton Depression Rating Scale (HAMD-17), Young Mania Rating Scale (YMRS), Clinical Global Impression Scale (CGI-S) and Treatment Emergent Symptom Scale (TESS) were used to assess participants at baseline and after 6 weeks of treatment. The plasma levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA)were detected at baseline and after 6 weeks to assess the level of oxidative stress. Results Repeated measures analysis of variance showed that the plasma level of SOD was higher in MECT group than in Li2CO3 group (F=15.26, P<0.01), and the level of MDA was higher in Li2CO3 group (F=18.18, P<0.01). The interactive effect of group and time was significant in GSH-Px level (F=6.39, P=0.02). The level of GSH-Px was lower in MECT group than in Li2CO3 group after 6 weeks (P<0.05). The CAT level was higher in the response patients than in non-response patients after 6 weeks (P<0.05). Con-clusions Both MECT treatment and Li2CO3 treatment can alter oxidative stress levels in patients with bipolar depression. The mechanisms underlying its therapeutic regimen may correct the imbalance of the plasma CAT level.
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Objective To investigate the effect of modified electroconvulsive therapy (MECT) with different anesthetics on efficacy of patients with treatment-resistant depression (TRD). Methods Ninety patients with TRD were enrolled in this study to receive a standard 8 times MECT. The HAMD-17 scale was evaluated before MECT and after the completion of the first, second, third, forth, sixth and eighth MECT session. The TESS scale was evaluated before MECT and after the completion of the last MECT session. Results Scores of HAMD-17 after the completion of the first, second, third, fourth, sixth and eighth MECT session were significantly reduced (P<0.05). There were significant differences of HAMD scales among the three groups since the first MECT session (P < 0.05). The remission rate of ketamine group, propofol group and mixed group was 96.7%, 43.3%, and 73.3% (P < 0.05). Conclusion MECT of ketamine anesthetic might contribute to the best effect of TRD.
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Objective:To explore the differences of the early response time between transcranial magnetic stimulation (rTMS ) and modified electroconvulsive therapy (MECT )in patients with first-episode depression.Methods:Totally 65 first-episode patients aged 18 -45 year were enrolled in the study.The diagnoses were made according tothe Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ)criteria for depression.The patients randomly received rTMS(n =33)or MECT (n =32).All patients received co-therapy of escitalopram (10 -20 mg /day).Stimulation (20 Hz)was performed five times a week for four weeks and,a total of 20 consecutive working days over the left dorsolateral prefrontal cortex(DLPFC).MECT group received MECT treatment 3 times a week for 3 weeks,a total of eight times.The Hamilton Depression Rating Scale-24 items (HAMD)was used to assess the severity of clinical symptoms and reduction rates.Results:Compared with the pa-tients in MECT group,the patients in rTMS group showed a less reduction rates [(25.0.±3.1),(34.4 ±7.7), (52.2 ±7.8),(69.1 ±8.3),vs(28.2 ±5.4),(38.8 ±5.1 ),(57.7 ±6.8),(75.4 ±8.6),Ps <0.05]in the first four weeks and the suicidal behavior scores reduced less in rTMS group in the first two weeks (P <0.05).Conclu-sion:It suggests that both rTMS at 20 Hz and MECT combined with escitalopram could improve the first-episode depression within a week.While the efficacy of rTMS combined with escitaloprm slightly less than MECT com-bined with essitaloprm in rapid response and reducing the suicide risk of acut period.
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Objective To compare the treatment accomplishmentsand adverse effects of the mixed- or single-application of etomidate and propofol during modified electroconvulsive therapy (MECT) in schizophrenics with hypertension. Methods Ninety hospitalized schizophrenics with hypertension undergoing MECT were ran-domly assigned to 3 groups: Group EP(etomidate = 0.3 mg/kg and propofol = 1.0 mg/kg), Group E (etomi-date = 0.7 mg/kg) and Group P (propofol = 2.0 mg/kg). Changes of SBP, DBP and HR were recorded before anesthesia, after induction, electrical stimulation instantly and 5 min after electrical stimulation. The average pe-riods of epileptic seizure (ESD), postictal suppression index (PSI) and the adverse reactions were also recorded. Results The ESD and PSI scores were significantly higher in Group EP and Group E than those in Group P (P < 0.05). SBP and DBP in Group E were significantly higher at the electrical stimulation instant than those af-ter induction (P < 0.05). SBP and DBP in Group P were significantly lower after induction than those before anesthesia(P < 0.05). The injection pain of Group EP and Group E were lower than that of Group P(P < 0.05). No significant differences were found among 3 groups in the adverse reactions such as nausea/vomiting anddys-phoria.Conclusion The mixed liquor of etomidate and propofol can extend the time of seizure, reduce the nega-tive reaction of cardiovascular system and adverse reactions during MECT in schizophrenics with hypertension.
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Objective To explore the effect of modified electroconvulsive therapy (MECT) on working memory in schizophrenia patients.Methods 2-back test paradigm was set to measure the performances of working memory.A total of 30 cases of schizophrenia were recruited and measured with accurate rate and reaction time on this tasks before and after treatment with MECT.Differences were analyzed between patients through MECT treatment and 30 patients through drug treatment.Results Repeated measure ment analysis of variance on the accurate rate ((66.70±9.82) ％,(67.61±6.83) ％,(80.72± 12.08) ％) and reaction time((1415.69± 258.51) ms,(1328.65±236.08) ms,(1094.45± 259.44) ms) of 2-back test were significant among three times of MECT (F=19.163,P＜0.001 ; F=13.084,P＜0.001).Schizophrenia patient's performance of error rate and reaction time of 2-back test were higher at the end of 2 weeks after treatment((80.72± 12.08)％;(1094.45± 259.44)ms) than before MECT treatment ((66.70±9.82) ％ ; (1415.69±258.51) ms).The difference between them were significant(t =-4.369,P＜0.001 ; t=5.596,P＜0.001).Schizophrenia patients performance of error rate and reaction time of 2-back test were higher at the end of 2 weeks after treatment((80.72± 12.08)％;(1094.45±259.44) ms) than at the end of 1 day after treatment((67.61±6.83)％;(1328.65±236.08) ms).The difference between them were significant(t=-5.416,P＜0.000; t=3.824,P=0.001).Schizophrenia patients performance of error rate of 2-back test were higher at the end of 2 weeks after treatment than drug treatment group ((73.67±10.41) ％),and the difference between them were significant(t=2.424,P=0.018).Conclusion Working memory functions in schizophrenia patients may be improved in varying degrees with MECT.