Psychiatric, Motor, and Autonomic Effects of Bifrontal ECT in Depressed Parkinson’s Disease Patients
- 1 May 2021
- journal article
- research article
- Published by American Psychiatric Association Publishing in The Journal of Neuropsychiatry and Clinical Neurosciences
- Vol. 33 (2), 161-166
- https://doi.org/10.1176/appi.neuropsych.20050133
Abstract
Objective: Depressive symptoms are a source of significant morbidity in Parkinson’s disease (PD). Electroconvulsive therapy (ECT) is a promising treatment for depression in PD (dPD); however, data remain limited, including data on optimal electrode placement. In this retrospective study, the investigators aimed to characterize the effects of bifrontal ECT for dPD on psychiatric and motor symptoms, as well as autonomic response. Methods: Clinical data were retrieved from a university-affiliated ECT service in Vancouver, British Columbia, for patients with dPD receiving bifrontal ECT between 2014 and 2018. Clinical Global Impression (depressive symptoms) and Unified Parkinson’s Disease Rating Scale (motor symptoms) scores and cardiovascular measurements during ECT, as well as doses of dopaminergic medications, were recorded. Results: Eight patients met criteria for inclusion. Six patients (75%) met response criteria for improvement of depressive symptoms, including 83% of patients who completed a full ECT course. Five patients went on to receive maintenance ECT, with only one patient relapsing by the 1-year follow-up (20%). For patients with motor scales reported, 60% showed a clinically significant improvement in motor symptoms. Among patients who completed ECT, a reduction in the median dopaminergic medication dose was also observed (−350 mg). Two patients discontinued ECT as a result of tolerability concerns. Participants demonstrated a relatively typical pattern of autonomic response to ECT, with low incidence of bradycardic events. Conclusions: The results provide preliminary evidence of the benefit of bifrontal ECT in dPD for both depressive and motor symptoms. The autonomic data suggest that most patients with dPD respond in a typical physiological manner to ECT stimulus; however, further investigation is needed.Keywords
This publication has 29 references indexed in Scilit:
- Systematic review and meta-analysis of bifrontal electroconvulsive therapy versus bilateral and unilateral electroconvulsive therapy in depressionThe World Journal of Biological Psychiatry, 2011
- Parkinson's disease: The quintessential neuropsychiatric disorderMovement Disorders, 2011
- Electric field strength and focality in electroconvulsive therapy and magnetic seizure therapy: a finite element simulation studyJournal of Neural Engineering, 2011
- Systematic review of levodopa dose equivalency reporting in Parkinson's diseaseMovement Disorders, 2010
- Efficacy and acceptability of selective serotonin reuptake inhibitors for the treatment of depression in Parkinson's disease: a systematic review and meta-analysis of randomized controlled trialsBMC Neurology, 2010
- Absence of Asystole During Bifrontal Stimulation in Electroconvulsive TherapyThe Journal of ECT, 2010
- Movement Disorder Society‐sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS): Scale presentation and clinimetric testing resultsMovement Disorders, 2008
- A systematic review of prevalence studies of depression in Parkinson's diseaseMovement Disorders, 2008
- Non-invasive brain stimulation for Parkinson's disease: a systematic review and meta-analysis of the literatureJournal of Neurology, Neurosurgery & Psychiatry, 2005
- Electroconvulsive therapy-induced hemodynamic changes unmask unsuspected coronary artery diseaseJournal of Clinical Anesthesia, 1990