Papakostas Y G, Markianos M, Pehlivanidis A, Zervas I M, Papadimitriou G N, Stefanis C
Psychiatry Department and University Mental Health, Research Institute, Athens University, Medical School, Greece.
Acta Psychiatr Scand. 1999 Jan;99(1):68-72. doi: 10.1111/j.1600-0447.1999.tb05386.x.
The relationship between the thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) and the duration of seizures induced by electroconvulsive therapy (ECT) in depressed patients was investigated. In a balanced-order cross-over design, 16 depressed women were given 0.4 mg TRH or placebo intravenously, 20 min before ECT in the first two sessions. In the third ECT session TRH was given just prior to ECT. Thyrotropin (TSH) levels at various sampling times, as well as the duration of seizures, were measured. There was a significant inverse correlation between plasma TSH concentrations 20 min after TRH administration (deltaTSH) and seizure duration. Furthermore, when patients were categorized according to their TSH response to TRH, the group with blunted responses (deltaTSH <6 microIU/ mL, n = 7) had a longer seizure time during ECT than the group with non-blunted responses (deltaTSH > 6 microIU/mL, n = 9). Finally, the seizure duration in the group with blunted TSH responses was reduced significantly when TRH was co-administered, while it remained unchanged in the group with non-blunted TSH responses. It is concluded that a blunted TSH response to TRH might indicate a seizure susceptibility as measured by the duration of seizures induced by ECT. The fact that TRH pre-administration had a reducing effect suggests that this substance might be involved in the pathophysiology of ECT-induced seizures.
研究了抑郁症患者促甲状腺激素（TSH）对促甲状腺激素释放激素（TRH）的反应与电休克治疗（ECT）诱发癫痫发作持续时间之间的关系。在平衡顺序交叉设计中，16名抑郁症女性在前两个ECT疗程中，于ECT前20分钟静脉注射0.4mg TRH或安慰剂。在第三个ECT疗程中，TRH在ECT即将开始前给予。测量了不同采样时间的促甲状腺激素（TSH）水平以及癫痫发作持续时间。TRH给药后20分钟时的血浆TSH浓度（△TSH）与癫痫发作持续时间之间存在显著负相关。此外，根据患者对TRH的TSH反应进行分类时，反应迟钝组（△TSH<6微国际单位/毫升，n = 7）在ECT期间的癫痫发作时间比反应不迟钝组（△TSH>6微国际单位/毫升，n = 9）更长。最后，当联合给予TRH时，TSH反应迟钝组的癫痫发作持续时间显著缩短，而TSH反应不迟钝组则保持不变。结论是，TSH对TRH反应迟钝可能表明存在癫痫易感性，这可通过ECT诱发的癫痫发作持续时间来衡量。预先给予TRH具有降低作用这一事实表明，该物质可能参与了ECT诱发癫痫发作的病理生理学过程。
