Popeo Dennis, Kellner Charles H
Med Hypotheses. 2009 Oct;73(4):468-9. doi: 10.1016/j.mehy.2009.06.053. Epub 2009 Aug 5.
Parkinson's disease (PD) is a chronic, progressive, degenerative disorder that affects over five million people worldwide. Pharmacotherapy with dopamine enhancing medications is the mainstay of treatment. Neurosurgical techniques, ranging from pallidotomy to deep brain stimulation (DBS) are used in refractory patients. Another treatment, electroconvulsive therapy (ECT), has repeatedly been shown to have beneficial effects in PD, but has never gained acceptance as a clinical treatment option. We review the literature on the use of ECT in PD, pointing out that ECT has beneficial effects on both the core motor symptoms of PD as well as the commonly occurring psychiatric co-morbidities. ECT is hypothesized to act in PD by enhancing dopamine neurotransmission, including increasing sensitivity of dopamine receptors. The beneficial effects of ECT in PD persist for variable periods. Maintenance ECT has been used to increase the length of benefit. The stigma surrounding ECT has likely been responsible for its lack of use in PD. We suggest that ECT has a role in the treatment of PD, both in patients with PD alone, or PD with co-occurring depression.
帕金森病（PD）是一种慢性、进行性、退行性疾病，全球有超过500万人受其影响。使用增强多巴胺的药物进行药物治疗是主要的治疗方法。从苍白球切开术到深部脑刺激（DBS）等神经外科技术用于难治性患者。另一种治疗方法，即电休克疗法（ECT），已多次被证明对帕金森病有有益效果，但从未被接受为一种临床治疗选择。我们回顾了关于在帕金森病中使用ECT的文献，指出ECT对帕金森病的核心运动症状以及常见的精神共病都有有益效果。ECT在帕金森病中的作用被推测为通过增强多巴胺神经传递，包括增加多巴胺受体的敏感性来实现。ECT在帕金森病中的有益效果持续不同的时间段。维持性ECT已被用于延长受益时间。围绕ECT的污名化可能是其在帕金森病中未被使用的原因。我们建议ECT在帕金森病的治疗中具有作用，无论是单独患有帕金森病的患者，还是同时患有帕金森病和抑郁症的患者。
