Sackeim H A
Department of Biological Psychiatry, New York State Psychiatric Institute, New York, USA.
J ECT. 1999 Mar;15(1):5-26.
Electroconvulsive therapy exerts a variety of anticonvulsant effects. The linkage between specific anticonvulsant effects and the efficacy of ECT is examined in relation to changes in seizure threshold, seizure duration, and seizure expression, and alterations in cerebral blood flow (CBF) and metabolism, and in EEG slow-wave activity. New findings are presented that the magnitude of the change in seizure threshold over the ECT course is associated with therapeutic outcome, particularly with right unilateral (RUL) ECT. New findings also indicate that the change in seizure threshold covaries with the magnitude of global reductions in CBF over the treatment course, is inversely related to some inhibitory aspects of seizure expression, and is independent of the cumulative decrease in seizure duration. Considerable evidence has accrued associating the anticonvulsant and antidepressant effects of ECT. However, critical experiments should be conducted in which the effects of augmenting and blocking anticonvulsant actions are studied in relation to efficacy.
电休克治疗具有多种抗惊厥作用。从癫痫发作阈值、发作持续时间、发作表现的变化，以及脑血流量（CBF）、代谢和脑电图慢波活动的改变等方面，研究了特定抗惊厥作用与电休克治疗疗效之间的联系。新的研究结果表明，在电休克治疗过程中癫痫发作阈值的变化幅度与治疗效果相关，特别是与右侧单侧（RUL）电休克治疗有关。新的研究结果还表明，癫痫发作阈值的变化与治疗过程中CBF整体降低的幅度共变，与癫痫发作表现的某些抑制方面呈负相关，且与癫痫发作持续时间的累积减少无关。已有大量证据表明电休克治疗的抗惊厥作用和抗抑郁作用之间存在关联。然而，应该进行关键实验，研究增强和阻断抗惊厥作用的效果与疗效之间的关系。
