Adrissi Jennifer, Nadkarni Neil A, Gausche Eric, Bega Danny
Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
Department of Psychiatry and Behavioral Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
J Huntingtons Dis. 2019;8(3):291-300. doi: 10.3233/JHD-190361.
Huntington's disease (HD) is a progressive neurodegenerative disease characterized by involuntary movements and neuropsychiatric decline. With suicide rates five times higher in patients with HD compared to the general population, there is a need for further research into the management of affective symptoms in these patients. Electroconvulsive therapy (ECT) has been long used as a treatment for severe or medication-refractory mood disorders and catatonia. There are some case studies demonstrating ECT's positive effect on depression and agitation in HD, but the data is limited.
In this single site case series, we review ECT use for four HD patients with medication-refractory depression and/or psychosis to better assess the utility of ECT in this population. We also compile and review the existing literature on the topic.
A single-center retrospective case series was conducted reviewing the indications, outcomes, and regimen of ECT treatments. Literature review was conducted via PubMed.
Four patients received ECT treatment during an inpatient hospitalization with three continuing maintenance therapy as an outpatient. All four had improvements in depression, agitation, and suicidal ideation leading to successful hospital discharge. One of the four patients also demonstrated subjective improvement in cognitive and motor symptoms after ECT initiation. Nineteen reported cases were identified through the literature review and are summarized.
This case series adds to the existing literature demonstrating the successful use of ECT for psychiatric symptoms in HD. Larger scale studies are warranted to further investigate the specific role and protocol for the use of ECT in the management of refractory depression and psychosis in this population.
亨廷顿舞蹈症（HD）是一种进行性神经退行性疾病，其特征为不自主运动和神经精神衰退。HD患者的自杀率是普通人群的五倍，因此有必要进一步研究这些患者情感症状的管理。电休克疗法（ECT）长期以来一直用于治疗严重或药物难治性情绪障碍和紧张症。有一些案例研究表明ECT对HD患者的抑郁和激越有积极作用，但数据有限。
在这个单中心病例系列中，我们回顾了ECT用于4例药物难治性抑郁和/或精神病的HD患者的情况，以更好地评估ECT在该人群中的效用。我们还汇编并回顾了关于该主题的现有文献。
进行了一项单中心回顾性病例系列研究，回顾了ECT治疗的适应症、结果和方案。通过PubMed进行文献回顾。
4例患者在住院期间接受了ECT治疗，其中3例作为门诊患者继续接受维持治疗。所有4例患者的抑郁、激越和自杀观念均有改善，从而成功出院。4例患者中有1例在开始ECT治疗后认知和运动症状也有主观改善。通过文献回顾确定了19例报告病例并进行了总结。
这个病例系列补充了现有文献，证明ECT成功用于HD患者的精神症状。有必要进行更大规模的研究，以进一步调查ECT在该人群难治性抑郁和精神病管理中的具体作用和方案。
