Singh Nagendra Madan, Sathyaprabha T N, Thirthalli Jagadisha, Andrade Chittaranjan
Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Indian J Psychiatry. 2018 Jan-Mar;60(1):17-23. doi: 10.4103/psychiatry.IndianJPsychiatry_88_18.
No electroconvulsive therapy (ECT) study on humans or in animal models has so far examined whether differently composed electrical stimuli exert different cardiac electrophysiological effects at constant electrical dose. The subject is important because cardiac electrophysiological changes may provide indirect information about ECT seizure quality as modulated by stimulus composition.
Adult female Wistar rats ( = 20/group) received fixed, moderately suprathreshold (18 mC) electrical stimuli. This stimulus in each of eight groups was formed by varying pulse amplitude, pulse width, pulse frequency, and stimulus duration. The electrocardiogram was recorded, and time and frequency domain variables were examined in 30 s epochs in preictal (30 s before electroconvulsive shock [ECS]), early postictal (starting 15 s after stimulation), and late postictal (5 h after ECS) periods. Alpha for statistical significance was set at < 0.01 to adjust for multiple hypothesis testing.
Cardiac electrophysiological indices in the eight groups did not differ significantly at baseline. At both early and late postictal time points, almost no analysis yielded statistically significant differences between groups for four time domain variables, including heart rate and standard deviation of R-R intervals, and for six frequency domain variables, including low-frequency power, high-frequency power, and total power.
Cardiac electrophysiological measures may not be helpful to identify differences in seizure quality that are driven by differences in the composition of electrical stimuli at constant, moderately suprathreshold electrical dose. The generalization of this conclusion to threshold electrical doses and to human contexts requires a study.
迄今为止，尚无关于人类或动物模型的电休克治疗（ECT）研究考察过在恒定电剂量下，不同组成的电刺激是否会产生不同的心脏电生理效应。这个问题很重要，因为心脏电生理变化可能会提供有关受刺激组成调节的ECT癫痫发作质量的间接信息。
成年雌性Wistar大鼠（每组20只）接受固定的、适度阈上（18 mC）电刺激。八组中的每组刺激均通过改变脉冲幅度、脉冲宽度、脉冲频率和刺激持续时间形成。记录心电图，并在癫痫发作前（电休克[ECS]前30秒）、发作早期（刺激后15秒开始）和发作后期（ECS后5小时）的30秒时段内检查时域和频域变量。为校正多重假设检验，将统计学显著性的α设定为<0.01。
八组的心脏电生理指标在基线时无显著差异。在发作早期和晚期的时间点，对于包括心率和R-R间期标准差在内的四个时域变量，以及包括低频功率、高频功率和总功率在内的六个频域变量，几乎没有分析得出组间有统计学显著差异。
在恒定的、适度阈上电剂量下，心脏电生理测量可能无助于识别由电刺激组成差异所驱动的癫痫发作质量差异。将这一结论推广到阈下电剂量和人类情况需要进一步研究。
