Zyss T, Adamek D, Zieba A, Vetulani J, Mamczarz J, Mika J
Pracowni EEG i PW Kliniki Neurologii Szpitala Uniwersyteckiego w Krakowie.
Psychiatr Pol. 2000 Jul-Aug;34(4):655-75.
Since the time of introducing ECT to the clinical practice, the method always raised questions regarding possibility that the current running through structures of a brain may evoke structural changes and, as a result, evoke convulsive attacks. Pathological changes (swelling, gliosis, atrophy, necrosis) were observed most often after "mega"--schemes including series of several to several hundred ECT treatments. Regime used nowadays including only 8-12 ECT sessions seems to be entirely safe. There are, however, only a few experimental works dealing with this problem. In 1992 research started on a new neurophysiological technique--transcranial magnetic stimulation (TMS) in depression. The advantage of this method is that is does not seem to evoke convulsive attacks. Prolonged rapid rate TMS (rTMS) seems to be particularly efficient in treatment of depression. Despite thousands of works describing various functional effects of TMS, there are obviously no researches on structural effects of the technique. In the case of experimental research on animals a few works were published and their results seem to be ambiguous. We have examined the influence of prolonged repetitive rTMS (B = 1.4 T, t = 5.5 min, f = 30 Hz), and standard ECT (I = 150 mA, t = 0.5 s, f = 50 Hz) on the structure of brain tissue in rats. Both groups of animals (n = 10) received 12 stimulation sessions. After the treatment the animals were routinely processed for electron microscopy (EM) and for light microscopy (LM). Our investigations suggest that the technique of ECT shows a considerable neurotoxic potential. In comparison to ECT--the rTMS method seems to be more safe.
自将电休克疗法(ECT)引入临床实践以来,该方法一直引发有关电流通过脑组织结构是否可能引起结构变化并进而引发惊厥发作的问题。病理变化(肿胀、胶质细胞增生、萎缩、坏死)最常出现在包括数次至数百次ECT治疗的“大剂量”方案之后。如今使用的仅包括8 - 12次ECT治疗的方案似乎完全安全。然而,仅有少数实验研究涉及此问题。1992年开始了一项关于抑郁症的新神经生理学技术——经颅磁刺激(TMS)的研究。该方法的优点是似乎不会引发惊厥发作。长时间快速重复经颅磁刺激(rTMS)在抑郁症治疗中似乎特别有效。尽管有成千上万篇描述TMS各种功能效应的研究,但显然没有关于该技术结构效应的研究。在动物实验研究方面,有少数研究发表,但其结果似乎并不明确。我们研究了长时间重复rTMS(B = 1.4 T,t = 5.5分钟,f = 30 Hz)和标准ECT(I = 150 mA,t = 0.5秒,f = 50 Hz)对大鼠脑组织结构的影响。两组动物(每组n = 10)均接受12次刺激治疗。治疗后,对动物进行常规处理以进行电子显微镜(EM)和光学显微镜(LM)检查。我们的研究表明,ECT技术显示出相当大的神经毒性潜力。与ECT相比,rTMS方法似乎更安全。