Department of Pathology and Cell Biology, Columbia University, USA.
Neuroscience. 2009 Dec 29;164(4):1557-64. doi: 10.1016/j.neuroscience.2009.09.051. Epub 2009 Sep 25.
Anatomical evidence of brain damage from electroconvulsive therapy (ECT) is lacking; but there are no modern stereological studies in primates documenting its safety. Magnetic seizure therapy (MST) is under development as a less invasive form of convulsive therapy, and there is only one prior report on its anatomical effects. We discerned no histological lesions in the brains of higher mammals subjected to electroconvulsive shock (ECS) or MST, under conditions that model closely those used in humans. We sought to extend these findings by determining whether these interventions affected the number of neurons or glia in the frontal cortex or hippocampus. Twenty-four animals received 6 weeks of ECS, MST, or anesthesia alone, 4 days per week. After perfusion fixation, numbers of neurons and glia in frontal cortex and hippocampus were determined by unbiased stereological methods. We found no effect of either intervention on volumes or total number or numerical density of neurons or glia in hippocampus, frontal cortex, or subregions of these structures. Induction of seizures in a rigorous model of human ECT and MST therapy does not cause a change in the number of neurons or glia in potentially vulnerable regions of brain. This study, while limited to young, healthy, adult subjects, provides further evidence that ECT and MST, when appropriately applied, do not cause structural damage to the brain.
脑损伤的解剖学证据缺乏;但在灵长类动物中,没有现代立体学研究证明其安全性。磁惊厥疗法(MST)作为一种侵入性较小的惊厥疗法正在开发中,仅有一份关于其解剖学影响的报告。在模拟人类使用条件非常接近的情况下,我们未发现接受电惊厥休克(ECS)或 MST 的高等哺乳动物的脑组织中有组织学损伤。我们试图通过确定这些干预措施是否影响前额皮质或海马体中的神经元或神经胶质细胞数量来扩展这些发现。24 只动物接受了 6 周的 ECS、MST 或单独麻醉,每周 4 天。灌注固定后,采用无偏立体学方法确定前额皮质和海马体中神经元和神经胶质细胞的数量。我们发现两种干预措施均未影响海马体、前额皮质或这些结构的亚区中神经元或神经胶质细胞的体积、总数或数值密度。在严格的人类 ECT 和 MST 治疗模型中诱导癫痫发作不会导致大脑潜在脆弱区域中神经元或神经胶质细胞数量的变化。这项研究虽然仅限于年轻、健康的成年受试者,但进一步证明了 ECT 和 MST 在适当应用时不会对大脑造成结构损伤。