Department of Psychiatry and Psychotherapy, University Hospital, Jena, Germany.
J Affect Disord. 2010 Sep;125(1-3):323-9. doi: 10.1016/j.jad.2010.02.110. Epub 2010 Mar 3.
Electroconvulsive therapy (ECT) has been shown to exhibit strong beneficial effects in the treatment of major depressive disorder (MDD). While the exact underlying mechanisms are under debate, a role for the sympathetic response upon ECT has been suggested. When assessing patients with MDD for autonomic function, however, a loss of vagal function is prominent.
Here, we aimed to assess the immediate effects of ECT on vagal activity and to test the hypothesis that surrogates of the latter correlate with therapeutic outcome.
Twenty patients with MDD who underwent ECT treatment were assessed regarding their vagal function using electrophysiological measures and determination of pancreatic polypeptide (PP), which is known to be released upon vagal stimulation. Parameters were correlated to the improvement of disease severity upon ECT treatment.
Patients showed a significant increase of PP shortly after ECT which correlated with clinical improvement. Furthermore, the described association with the sympathetic phase after ECT could be verified.
ECT increases vagal activity which might be associated with the beneficial effect seen following this treatment. PP elevation after administration of ECT might be a useful parameter to estimate the degree of such vagal stimulation after treatment.
电痉挛疗法（ECT）已被证明在治疗重度抑郁症（MDD）方面具有强大的有益作用。虽然确切的潜在机制仍存在争议，但有人认为 ECT 会引起交感反应。然而，在评估 MDD 患者的自主功能时，突出表现为迷走神经功能丧失。
本研究旨在评估 ECT 对迷走神经活性的即时影响，并验证迷走神经活性的替代指标与治疗效果相关的假设。
对 20 名接受 ECT 治疗的 MDD 患者进行了迷走神经功能评估，方法包括电生理测量和测定已知在迷走神经刺激时释放的胰多肽（PP）。将参数与 ECT 治疗后疾病严重程度的改善相关联。
患者在 ECT 后不久即表现出 PP 的显著增加，这与临床改善相关。此外，还可以验证与 ECT 后交感阶段的描述性关联。
ECT 增加了迷走神经活性，这可能与这种治疗后的有益效果有关。ECT 后 PP 升高可能是评估治疗后迷走神经刺激程度的一个有用指标。
