Intra- and Inter-Network connectivity of the default mode network differentiates Treatment-Resistant depression from Treatment-Sensitive depression.

Understanding why some patients with depression remain resistant to antidepressant medication could be elucidated by investigating their associated neural features. Although research has consistently demonstrated abnormalities in the anterior cingulate cortex (ACC) - a region that is part of the default mode network (DMN) - in treatment-resistant depression (TRD), a considerable research gap exists in discerning how these neural networks distinguish TRD from treatment-sensitive depression (TSD). We aimed to evaluate the resting-state functional connectivity (rsFC) of the ACC with other regions of the DMN to better understand the role of this structure in the pathophysiology of TRD.

Continuation or maintenance ECT for schizophrenia: A narrative review of case report data.

Objective: This review aimed to address the limited evidence on the efficacy of continuation or maintenance electroconvulsive therapy (C/M-ECT) in schizophrenia, with a focus on international case reports and series due to the scarcity of randomised controlled trials.

Materials And Methods: Electronic database searches were conducted to identify case reports or series evaluating the efficacy of C/M-ECT in patients with schizophrenia or schizoaffective disorder.

Results: C/M-ECT treatment span varied from 3 months to 36 years ( = 30 months; = 43.

Examining the clinical effectiveness of continuation and maintenance electroconvulsive therapy in schizophrenia.

Objective: There are few studies that examine the effectiveness of Continuation/Maintenance Electroconvulsive Therapy (C/M-ECT) in schizophrenia, despite the documented effectiveness of acute ECT treatment. We aimed to investigate the clinical effectiveness of C/M-ECT for in-patients with Schizophrenia in a naturalistic setting. We examined the medical records of 46 in-patients who were diagnosed with Schizophrenia and had received C/M-ECT belonging to non-acute extended care service in a public psychiatry hospital in Sydney, Australia.

Abnormal habenula functional connectivity characterizes treatment-resistant depression.

Background: A significant proportion of patients with major depressive disorder are resistant to antidepressant medication and psychological treatments. A core symptom of treatment-resistant depression (TRD) is anhedonia, or the inability to feel pleasure, which has been attributed to disrupted habenula function - a component of the reward network. This study aimed to map detailed neural circuitry architecture related to the habenula to identify neural mechanisms of TRD.

ECT in the time of the COVID-19 pandemic.

Objective: The recent and ongoing COVID-19 pandemic outbreak has placed a huge burden on healthcare systems worldwide. This emergent situation applies invariably to mental health services, and policy makers have issued new directives to adequately deal with this crisis. The COVID-19 outbreak poses special challenges to the administration of electroconvulsive therapy (ECT) since the anaesthetic induction is an aerosol-generating process.

Naturalistic outcomes of continuation right unilateral ultrabrief ECT in major depression: a retrospective chart review.

Objective: Continuation treatment of major depression following an acute course of electroconvulsive treatment (ECT) may be often required to prevent relapse. Data on continuation phase of right unilateral ultrabrief ECT are sparse and there are doubts if it is inherently capable of relapse prevention.

Methods: All consecutive adult patients with major depression who received the first 'run' of continuation phase of right unilateral ultrabrief ECT over a 10-year period were routinely followed up.

Dissociation of identity following left parietal haematoma - a single case report.

Objectives: Dissociative identity disorder in relation to brain injury has only rarely been reported in literature. This case report, which illustrates a de novo onset of dissociative identity for the first time in an elderly man who had a left parietal haematoma, adds to this scant literature base and supports an integrative view of bridging the dichotomy between organic and functional to explain complex psychiatric phenomena.

Methods: It is a single case report collected through serial semi-structured interviews of the patient and his family over a 12-week period.

'Size does matter': Prophylactic gonadectomy in a case of Swyer syndrome.

Swyer syndrome also known as pure or complete gonadal dysgenesis is a very rare disorder of sex development wherein the individuals are phenotypically females with 46, XY genotype and preserved mullerian structures. These individuals characteristically have dysgenetic streak gonads which carry an increased risk of malignant transformation. Prophylactic gonadectomy is highly recommended as soon as a clinical diagnosis is established to diminish the chances of tumor development.

Concomitant Transcranial Direct Current Stimulation With Ultrabrief Electroconvulsive Therapy: A 2-Week Double-Blind Randomized Sham-Controlled Trial.

Objective: The feasibility and effectiveness of concomitant use of transcranial direct current stimulation (tDCS) with electroconvulsive therapy (ECT) has not been investigated. The study principally aimed at determining whether tDCS when combined with ECT improved the speed of antidepressant response. Secondarily, the ease of generation of seizures during electroconvulsive therapy and cognitive outcomes were investigated.

Rapid amelioration of severe manic episodes with right unilateral ultrabrief pulse ECT: a case series of four patients.

Objective: The aim of this small case series is to describe four cases of severe mania, where ultrabrief pulse electroconvulsive therapy (ECT) was used as a primary mode of treatment.

Methods: A retrospective file review was undertaken of four patients identified as having received ultrabrief pulse ECT for severe mania. The outcome measures for treatment efficacy were the Young Mania Rating Scale (YMRS) and Clinical Global Impression (CGI).

Autobiographical and subjective memory with right unilateral high-dose 0.3-millisecond ultrabrief-pulse and 1-millisecond brief-pulse electroconvulsive therapy: a double-blind, randomized controlled trial.

Objective: Shortening the pulse width to 0.3 millisecond holds neurophysiological and clinical promise of making electroconvulsive therapy (ECT) safer by reducing cognitive adverse effects. The exclusive effects of pulse width on autobiographical and subjective memory are largely unstudied.

Acute antidepressant effects of right unilateral ultra-brief ECT: a double-blind randomised controlled trial.

Background: Shortening the pulse width to 0.3 ms holds neurophysiological and clinical promise of making ECT safer by limiting cognitive side effects. However, the antidepressant effects of right ultra-brief unilateral ECT are under contention.

Pharmacokinetics of tacrolimus in adult renal transplant recipients.

Background: The success of an immunosuppressive drug therapy depends on the extent of exposure to the drugs (the blood levels and duration), which is measured as the area under the curve (AUC). Tacrolimus shows considerable variability in its pharmacokinetics, with poor correlation between the tacrolimus trough level and systemic exposure, as measured by the AUC of concentration time. Monitoring trough levels helps not only in reducing nephrotoxiicity but also in reducing the chances of acute rejection; although there is no international consensus, the trough concentration is used to determine dosing and the AUC for calculating the exposure of the patient to the drug.

Comparison of ictal electroencephalogram between ultrabrief- and brief-pulse right unilateral electroconvulsive therapy: a multitaper jackknife analysis.

Objective: Characterization of the ictal electroencephalogram (EEG) generated during ultrabrief pulse electroconvulsive therapy (ECT) is important to progress its use in routine ECT practice particularly in indicating treatment efficacy. The study compared 2- to 5-Hz and 5.2- to 13-Hz bands of the ictal EEG signal between brief- and ultrabrief-pulse ECT.

Comparison of antidepressant effects between brief and ultrabrief pulse unilateral electroconvulsive therapy: brief report of a randomized double-blind trial.

Objective: Electroconvulsive therapy (ECT) treatments with briefer pulse widths have recently shown promise.

Methods: Consenting patients with major depression were randomized in a double-blind protocol into 1-millisecond brief pulse (n = 10) or 0.3-millisecond ultrabrief pulse (n = 12) right unilateral at thrice-weekly, 6 times the threshold dose treatments at identical charge rates.

Impact of hyperventilation on stimulus efficiency during the early phase of an electroconvulsive therapy course: a randomized double-blind study.

Objective: The question whether hyperventilation during electroconvulsive therapy (ECT) can improve stimulus efficiency is as yet unanswered.

Methods: Twenty-five consecutive consenting patients (N = 25) with major depression who were administered ECT entered into the study. Right unilateral ECT at thrice the threshold dose was administered using Mecta spECTrum 5000Q (Mecta Corp, Lake Oswego, Ore), with standard titration procedures and stimulus configurations.

Impact of depression heterogeneity on attention: an auditory oddball event related potential study.

Background: Major depressive disorder is associated with a reduced ability to attend and concentrate, however, the extent to which attentional impairment is dependent on subtype remains to be clarified.

Methods: Event-related potentials (ERPs) associated with a well-validated auditory oddball, selective attention task, were recorded to determine the impact of melancholia (n=57) versus non-melancholia (n=48) relative to controls (n=116).

Results: The key findings were an exaggeration of the P200 to both non-target and target stimuli and a reduction in the P300 to targets in patients with melancholia, relative to patients with non-melancholia and controls.

Ictal electroencephalographic characteristics during electroconvulsive therapy: a review of determination and clinical relevance.

Objective: The usefulness of electroencephalogram (EEG) during electroconvulsive therapy (ECT) is not limited to the duration of seizure. The use of studying its characteristics has gained attention among specialized ECT researchers. This review attempts to put the literature in this area of ictal EEG in ECT into a practical perspective.

Seizure threshold estimation by formula method: a prospective study in unilateral ECT.

Formula methods of estimating seizure threshold in bilateral electroconvulsive therapy (ECT) have been successful in 75% (at the first ECT) and 80% (at the sixth ECT) of treatments (Gangadhar et al., 1998). This study showed the same results for unilateral (UL) ECT patients.

Cardiovascular response during ECT: a cross-over study across stimulus conditions.

This study examined the effect of stimulus conditions on rate pressure product (RPP) during ECT. Seizure duration as well as baseline, ictal, and postictal RPP were recorded in 28 patients who received ECT under four stimulus conditions (unilateral threshold, unilateral suprathreshold, bilateral threshold, and bilateral suprathreshold). Seizure duration did not differ between the stimulus conditions.