Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta.
J ECT. 2022 Sep 1;38(3):185-191. doi: 10.1097/YCT.0000000000000833. Epub 2022 Mar 1.
Magnetic seizure therapy (MST) is a novel convulsive therapy that has been shown to have antidepressant efficacy comparable to electroconvulsive therapy (ECT) with fewer cognitive side effects. However, the cardiovascular (CVS) effects of high frequency MST in comparison to ECT have not been investigated.
Forty-five patients with depression received 6 treatment sessions of 100 Hz MST versus 6 bifrontal ECT treatments in a nonrandomized comparative clinical design. Data on CVS function including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and rate pressure product (RPP) were collected at baseline (T0), after the induction of anesthesia but before the electrical stimulation (T1), during convulsion (T2), 2 minutes after cessation of motor seizure (T3), 5 minutes after cessation of motor seizure (T4), and 10 minutes after cessation of motor seizure (T5). Comparisons were made with baseline data and between MST and ECT groups.
There were statistically significant elevations in the maximum HR, SBP, DBP, and RPP in patients receiving ECT compared with MST both in the initial and sixth treatments (all P < 0.05). Particularly, at T2, the ECT group had significantly higher HR, SBP, DBP, and RPP than those in MST group both in initial and sixth treatment (all P < 0.001). At the sixth treatment, the ECT group had significantly higher SBP, DBP, and RPP during the treatment than in the MST group (all P < 0.001).
The anesthetic choices for this study may limit the generalizability of our findings. The sample size was relatively small.
Compared with ECT, high-frequency MST has fewer CVS side effects and may be a safer option for depression patients with CVS disorders.
磁惊厥疗法（MST）是一种新型的惊厥疗法，已被证明具有与电惊厥疗法（ECT）相当的抗抑郁疗效，且认知副作用较少。然而，高频 MST 与 ECT 相比的心血管（CVS）效应尚未被研究。
45 名抑郁症患者在非随机对照临床设计中接受了 100Hz MST 治疗 6 个疗程，或接受了 6 个双额 ECT 治疗。在基线（T0）、麻醉诱导后但在电刺激前（T1）、惊厥期间（T2）、运动性惊厥停止后 2 分钟（T3）、运动性惊厥停止后 5 分钟（T4）和运动性惊厥停止后 10 分钟（T5）收集 CVS 功能的数据，包括心率（HR）、收缩压（SBP）、舒张压（DBP）和心率血压乘积（RPP）。与基线数据进行比较，并比较 MST 和 ECT 组之间的差异。
与 MST 相比，接受 ECT 的患者在初始和第六次治疗时的最大 HR、SBP、DBP 和 RPP 均有统计学显著升高（均 P <0.05）。特别是在 T2，在初始和第六次治疗时，ECT 组的 HR、SBP、DBP 和 RPP 均明显高于 MST 组（均 P <0.001）。在第六次治疗时，ECT 组在治疗期间的 SBP、DBP 和 RPP 均明显高于 MST 组（均 P <0.001）。
本研究的麻醉选择可能限制了我们发现的普遍性。样本量相对较小。
与 ECT 相比，高频 MST 对心血管系统的副作用较小，可能是患有心血管系统疾病的抑郁症患者更安全的选择。
