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Pilot Study of Cerebral Hemodynamics in Depressive Patient Under Electroconvulsive Therapy.

Neuropsychiatr Dis Treat

December 2024

Research Center of Educational Neuroscience, School of Educational Science, Huazhong University of Science and Technology, Wuhan City, Hubei Province, People's Republic of China.

Article Synopsis
  • Major depressive disorder (MDD) is a complex condition that can be hard to treat, and Electroconvulsive therapy (ECT) shows promise but its workings are not fully understood.
  • This study used functional Near-Infrared Spectroscopy (fNIRS) to compare the brain activity of a male MDD patient to that of 26 healthy controls before and after ECT, focusing on how ECT affects cerebral blood flow and brain networks.
  • Results indicated that the MDD patient had lower brain activity and connectivity at the start, but after ECT, these measures improved significantly, suggesting that ECT can effectively alter brain function in depressed patients and that fNIRS is a valuable tool for studying these changes.
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Background: Electroconvulsive therapy (ECT) is a medical procedure for treating severe depression and other mental health disorders, with anesthesia management being crucial for patient safety. Despite extensive research on factors influencing seizure quality during ECT, the impact of pre-ECT anxiety remains insufficiently explored.

Methods: This prospective observational study aimed to investigate the influence of pre-ECT anxiety, as measured by the Amsterdam Preoperative Anxiety and Information Scale, on electroencephalogram ictal characteristics during ECT and to explore anesthesia-related factors that may enhance seizure quality.

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Although electroconvulsive therapy (ECT) is effective for treating depression, schizophrenia, and mania, cognitive adverse effects may limit use. One possible mechanism for these effects includes cholinergic transmission alterations, supporting potential use of cholinesterase inhibitors for prevention and treatment of these cognitive deficits. The objective of this review is to determine efficacy and safety of cholinesterase inhibitors clinically used for dementia in reducing ECT cognitive adverse effects.

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