Trifu Simona, Sevcenco Anca, Stănescu Monica, Drăgoi Ana Miruna, Cristea Mihai Bogdan
Department of Clinical Neurosciences, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Faculty of Psychology and Educational Sciences, University of Bucharest, 050663 Bucharest, Romania.
Exp Ther Med. 2021 Nov;22(5):1281. doi: 10.3892/etm.2021.10716. Epub 2021 Sep 9.
Electroconvulsive therapy (ECT) is a technique that has been used since 1938 to treat several psychiatric disorders as a replacement for chemically induced seizures. Despite its history of stigma, controversy and low accessibility, ECT is found to be beneficial and efficient in severe cases of depression where medication fails to bring results. Titration tables developed over time, based on evidenced-based medicine, have made this treatment technique safe and, in some cases, the first choice of treatment. The aim of the review was to summarize the research conducted on the efficacy of ECT on major depressive disorder and variables studied such as technique, comorbidities and medication as well as the effects and outcomes of this procedure. At the same time, the application and correlations with other psychiatric and neurological disorders, including catatonia, agitation and aggression in individuals with dementia, schizophrenia, and epilepsy were assessed. There are no statistically demonstrated effects due to the fact that a small number of moderate-quality studies have been published; however, the combination of ECT technique with standard medication and care, can improve patient outcome. Furthermore, with regard to ECT, widespread and robust volume changes in both cortical and subcortical regions have been shown. Antidepressant response and volumetric increases appear to be limited by the specific neuroplasticity threshold of each patient.
电休克疗法（ECT）自1938年以来一直被用于治疗多种精神疾病，作为化学诱导癫痫发作的替代方法。尽管其存在污名化历史、争议且可及性较低，但在药物治疗无效的重度抑郁症病例中，ECT被发现是有益且有效的。随着时间的推移，基于循证医学制定的滴定表使这种治疗技术变得安全，在某些情况下甚至成为首选治疗方法。本综述的目的是总结关于ECT对重度抑郁症疗效的研究，以及所研究的变量，如技术、合并症和药物治疗，还有该治疗程序的效果和结果。同时，评估了ECT与其他精神和神经疾病的应用及相关性，包括痴呆症、精神分裂症和癫痫患者的紧张症、激越和攻击行为。由于发表的高质量研究数量较少，尚无统计学上证实的效果；然而，ECT技术与标准药物治疗和护理相结合，可以改善患者的治疗效果。此外，关于ECT，已显示皮质和皮质下区域均存在广泛且显著的体积变化。抗抑郁反应和体积增加似乎受到每个患者特定神经可塑性阈值的限制。
