In the NIMH-sponsored study, Dr. Harold Sackeim and colleagues from Columbia University randomly assigned 90 depressed patients to either right sided or bilateral ECT, using either a traditional electrical pulse or a newer “ultrabrief pulse”, and measured clinical response and cognitive side effects.
The study found that 73 % of the depressed subjects who received the ultrabrief pulse responded, compared with a 65% response from subjects who received the ‘gold standard’ bilateral older form. Importantly, the ultrabrief group had less severe cognitive side effects than the other group. “The use of an ultrabrief stimulus markedly reduces adverse cognitive effects and, when coupled with markedly suprathreshold right unilateral ECT, also preserves efficacy,” write Dr. Sackeim and colleagues.
In a related editorial in the same edition of 'Brain Stimulation', Dr. Bernard Lerer, a psychiatrist from Israel not involved in the study, wrote “The paper by Sackeim and colleagues in the current issue of 'Brain Stimulation' shows that use of an ultrabrief stimulus has remarkably few, if any, effects on cognitive function without loss of efficacy. The results provide convincing evidence derived from a randomized controlled trial. … If supported by additional controlled studies and borne out by clinical experience in the field, these findings will be an important further step forward in the practice of ECT. They also have intriguing implications for our understanding of how the treatment works, a conundrum that has not been resolved in the 73 years since convulsive therapy was first introduced. ”
Dr. Lerer went on to comment, “Overall, these are interesting times for brain stimulation therapies in general and ECT in particular. Ultrabrief stimulation is an exciting development in the optimization of ECT. It could turn out to be a pivotal step in an exciting cascade of events that may radically alter the treatment of depression and other psychiatric disorders.”
In another accompanying editorial reasoning from the physics of brain stimulation, Dr. Cameron McIntyre, a biomedical engineer from the Cleveland Clinic, commented that, “a first principals analysis of ECT stimulation parameters, along with the results of Sackeim et al, suggest that we should rethink the dogma of standard clinical ECT settings and work to optimize the therapy by bridging scientific understanding with clinical evaluation.”
“This pioneering and landmark article, with accompanying diverse viewpoints and editorials, is exactly the new approach to brain stimulation that we hope to foster,” writes Dr. Mark S. George, MD, Editor-in-Chief of 'Brain Stimulation'. Knowledge and approaches from the different techniques are starting to cross-fertilize, with important changes in theory and clinical practice. The field requires a multidisciplinary approach for full understanding.
Jayne Dawkins | alfa
Drought hits rivers first and more strongly than agriculture
06.09.2018 | Max-Planck-Institut für Biogeochemie
Landslides triggered by human activity on the rise
23.08.2018 | European Geosciences Union
Scientists at the Max Planck Institute for Polymer Research (MPI-P) in Mainz (Germany) together with scientists from Dresden, Leipzig, Sofia (Bulgaria) and Madrid (Spain) have now developed and characterized a novel, metal-organic material which displays electrical properties mimicking those of highly crystalline silicon. The material which can easily be fabricated at room temperature could serve as a replacement for expensive conventional inorganic materials used in optoelectronics.
Silicon, a so called semiconductor, is currently widely employed for the development of components such as solar cells, LEDs or computer chips. High purity...
Augsburg chemists present a new technology for compressing, storing and transporting highly volatile gases in porous frameworks/New prospects for gas-powered vehicles
Storage of highly volatile gases has always been a major technological challenge, not least for use in the automotive sector, for, for example, methane or...
When we put water in a freezer, water molecules crystallize and form ice. This change from one phase of matter to another is called a phase transition. While this transition, and countless others that occur in nature, typically takes place at the same fixed conditions, such as the freezing point, one can ask how it can be influenced in a controlled way.
We are all familiar with such control of the freezing transition, as it is an essential ingredient in the art of making a sorbet or a slushy. To make a cold...
Thin organic layers provide machines and equipment with new functions. They enable, for example, tiny energy recuperators. In future, these will be installed...
Das Zusammenspiel aus Struktur und Dynamik bestimmt die Funktion von Proteinen, den molekularen Werkzeugen der Zelle. Durch Fortschritte in der...
17.10.2018 | Event News
16.10.2018 | Event News
02.10.2018 | Event News
18.10.2018 | Life Sciences
18.10.2018 | Earth Sciences
18.10.2018 | Life Sciences