Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bangalore, 560 029, India.
Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, 560 029, India.
Asian J Psychiatr. 2018 Mar;33:78-83. doi: 10.1016/j.ajp.2018.03.001. Epub 2018 Mar 2.
Studies have examined the effects of electroconvulsive therapy (ECT) on human cardiac electrophysiology. However, no study has so far examined whether these effects vary with the magnitude of the electrical dose used to elicit the seizure. Because the benefits and adverse effects of the ECT seizure are dose-dependent, we examined the effects of different electrical doses of electroconvulsive shocks (ECS) on cardiac electrophysiology in an animal model with a view to determine whether cardiac electrophysiology could be a useful proxy to evaluate the quality of the ECT seizure.
Adult female Wistar rats (n = 20/group) received sham, low dose (10 mC), moderate dose (18 mC), or high dose (25 mC) ECS. The electrocardiogram (ECG) was recorded and was analyzed for time and frequency domain variables in 30 s epochs in preictal (30 s before ECS), early postictal (starting 15 s after stimulation) and late postictal (5 h after ECS) periods.
ECS was associated with substantial changes in most time and frequency domain measures during the early postictal period; a strong parasympathetic effect was observed. However, the effects of different ECS doses did not differ for any variable. All changes returned to levels that were similar to those of the sham controls in the late postictal period.
The effect of ECS on time and frequency domain cardiac electrophysiological measures was not dose-dependent. This suggests that if higher electrical doses are associated with stronger central seizures, ECG-derived variables may not be useful proxies for the quality of the central seizure. The generalization of this conclusion from animal to clinical contexts requires study.
已有研究探讨了电痉挛疗法（ECT）对人体心脏电生理学的影响。然而，迄今为止，尚无研究检验这些影响是否随引发癫痫发作的电剂量大小而变化。由于 ECT 癫痫发作的获益和不良反应与剂量有关，我们在动物模型中检验了不同电痉挛刺激（ECS）剂量对心脏电生理学的影响，旨在确定心脏电生理学是否可以作为评估 ECT 癫痫发作质量的有用替代指标。
成年雌性 Wistar 大鼠（每组 n=20）接受假刺激、低剂量（10 mC）、中剂量（18 mC）或高剂量（25 mC） ECS。记录心电图（ECG），并在发作前（ECT 前 30s）、早期发作后（刺激后 15s 开始）和晚期发作后（ECT 后 5h）的 30s 时程内，对时间和频域变量进行分析。
ECS 后，在早期发作后期间大多数时间和频域指标均发生明显变化，观察到强烈的副交感神经效应。然而，不同 ECS 剂量之间的任何变量均无差异。在晚期发作后，所有变化均恢复至与假刺激对照组相似的水平。
ECS 对时间和频域心脏电生理测量的影响与剂量无关。这表明，如果更高的电剂量与更强的中枢癫痫发作相关，那么 ECG 衍生变量可能不是评估中枢癫痫发作质量的有用替代指标。从动物到临床环境的这种结论的推广需要进一步研究。
