癫痫发作后 EEG 分形维数和频谱功率预测单侧 ECT 对抑郁症的反应。
Post-seizure EEG fractal dimension and spectral power predict antidepressant response to unilateral ECT.
机构信息
JAGADISHA, Assistant Professor of Psychiatry, National Institute of Mental Health & Neurosciences, Bangalore - 560029.
出版信息
Indian J Psychiatry. 2003 Jan;45(1):16-20.
BACKGROUND
Measures of EEG during ECT, for example, smaller post-seizure fractal dimension have predicted antidepressant response. The earlier study on this subject used bilateral ECT. This study aims to examine if this finding holds good even for unilateral ECT, using both fractal dimension and spectral power analysis of EEG.
METHODS
Fifty-one right-handed, drug-free patients with major depressive disorder received right unilateral ECTs at 2.5 times their seizure threshold. A rater blind to the clinical data measured fractal dimension and spectral power of EEG during their second ECT. Depression was rated using Hamilton's Rating Scale for Depression at baseline and on the 3rd, 7th and 14th days following ECT.
RESULTS
Thirty-five good quality EEG recordings were analyzed. Seventeen patients reached criteria for early response of more than median percent improvement on HRSD on both 7th and 14th day. Univariate analysis showed smaller fractal dimension and spectral power (greater post-seizure EEG suppression) in early responders compared to the late responders. This was confirmed by multivariate discriminant function analysis. None of the other clinical, treatment or EEG parameters predicted early response.
CONCLUSIONS
Effective seizure during unilateral ECT may be characterized by high post-seizure EEG suppression.
背景
例如，在 ECT 期间测量 EEG 的指标，如较小的癫痫发作后分形维数，已预测抗抑郁反应。更早的关于这一主题的研究使用了双侧 ECT。本研究旨在使用 EEG 的分形维数和频谱功率分析来检验即使对于单侧 ECT，这一发现是否仍然成立。
方法
51 名右利手、未使用药物的重性抑郁症患者以 2.5 倍的癫痫发作阈值接受右侧单侧 ECT。一位对临床数据盲的评分者在第二次 ECT 期间测量 EEG 的分形维数和频谱功率。在 ECT 前、ECT 后第 3、7 和 14 天使用汉密尔顿抑郁评定量表（Hamilton's Rating Scale for Depression）评定抑郁。
结果
分析了 35 份高质量 EEG 记录。17 名患者在第 7 天和第 14 天的 HRSD 上均达到大于中位数的改善百分比的早期反应标准。单变量分析显示，早期反应者的分形维数和频谱功率（更大的癫痫发作后 EEG 抑制）较小，与晚期反应者相比。这一结果得到了多元判别函数分析的证实。其他临床、治疗或 EEG 参数均不能预测早期反应。
结论
单侧 ECT 期间有效的癫痫发作可能表现为高癫痫发作后 EEG 抑制。
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