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幅度决定的发作值,电场建模和电疗法对抗抑郁药物和认知结果

Christopher C Abbott¹, Jeremy Miller², Danielle Farrar²

¹Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA. cabbott@salud.unm.edu.

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology

|January 11, 2024

概括

电治疗 (ECT) 的幅度可能是个性化的. 发作值 (STa) 与大脑电场 (E-field) 幅度和抗抑郁药物结果相关,这表明个性化的ECT参数可以提高治疗效率.

科学领域:

神经科学是一个神经科学.
精神病学是一个精神病学.
生物医学工程生物医学工程

背景情况:

目前的电治疗 (ECT) 脉冲振幅是固定的 (800-900 mA),没有明确的理由.
以前的研究表明,更高的电场 (E-field) 强度可以改善抗抑郁药的效果,但会影响认知.
与固定幅度ECT相比,幅度决定的位 (STa) 可能会降低E场的变化.

研究的目的:

调查STa,E场大小和经过ECT的老年抑郁症患者的临床结果之间的关系.
评估基于E-field建模的个性化ECT振幅的潜力.

主要方法:

29名患有抑郁症的老年人 (50-80岁) 接受了ECT.
在第一个治疗期间测量了幅度决定的发作值 (STa).
大脑成像,抑郁症和神经心理评估进行了ECT前,中和后.
脑电场大小 (Ebrain) 被计算为右单边 (RUL) 电极放置.

主要成果:

每单位电流的Ebrain (Ebrain/I) 与STa.相对应.
在中期ECT和切换到双门放置后,STa与抗抑郁药的结果有关.
Ebrain/I显示了效果大小与类别流性的变化有很大的关联.

结论:

STa和Ebrain/I之间的关系支持临床前发现,并验证了ECT E场建模.
基于E场建模或STa的个人化ECT振幅可以增强治疗参数选择.
个性化ECT具有改善临床结果和认知副作用管理的潜力.

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