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Changes in Cerebral Hemodynamic Among Patients With Schizophrenia or Bipolar Disorder Receiving Electroconvulsive
Keng-Hong Chhoa1, Soon-Kiat Chiang2, Kheng-Yee Ong3
1Sarawak General Hospital, Sarawak, Malaysia.
The Journal of ECT
|January 24, 2025
Summary
Functional near-infrared spectroscopy (fNIRS) objectively monitored electroconvulsive therapy (ECT) effects in schizophrenia and bipolar disorder patients. fNIRS revealed significant prefrontal cortex hemodynamic changes correlating with symptom improvement.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Imaging
Background:
- Limited studies evaluate electroconvulsive therapy (ECT) treatment effects.
- Functional near-infrared spectroscopy (fNIRS) provides a cost-effective method for assessing cerebral hemodynamics.
Purpose of the Study:
- To utilize fNIRS to evaluate the therapeutic effects of ECT in patients with schizophrenia or bipolar disorder (manic phase).
- To establish objective neuroimaging indicators for ECT monitoring in these patient groups.
Main Methods:
- Recruited 30 patients with mania and 31 with schizophrenia, each receiving 6 ECT sessions.
- Assessed symptom severity using the Positive and Negative Syndrome Scale and Young Mania Rating Scale.
- Measured prefrontal cortex hemodynamic response using fNIRS during a verbal fluency test at baseline and post-ECT.
Main Results:
- Significant reductions in symptom severity scores (P < 0.001) were observed after ECT sessions.
- fNIRS showed significant increases in oxy-hemoglobin (HbO2) in the right ventrolateral prefrontal cortex and left dorsolateral prefrontal cortex (P < 0.05).
- Correlations found between reduced symptom severity and increased HbO2 levels in both patient groups (P < 0.05).
Conclusions:
- ECT significantly improves symptom severity in patients with schizophrenia and bipolar disorder (manic phase).
- fNIRS monitoring of right ventrolateral prefrontal cortex and left dorsolateral prefrontal cortex activation serves as an objective indicator for ECT efficacy.
