Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, 11 Guangqian Road, Suzhou 215137, Jiangsu, China.
Shanghai Key Laboratory of Psychotic Disorders, Department of EEG and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China.
Psychiatry Res. 2022 Jun;312:114523. doi: 10.1016/j.psychres.2022.114523. Epub 2022 Mar 22.
Electroconvulsive therapy (ECT) can effectively reduce the symptoms of schizophrenia, but may also impair cognitive function. A potential alternative is magnetic seizure therapy (MST), which has shown comparable efficacy with less severe cognitive disruption. This study compared ECT to MST for clinical efficacy and cognitive side effects. In addition, we examined the possible contributions of hippocampal volume changes and enhanced brain derived neurotrophic factor (BDNF) signaling to the therapeutic responses. Thirty-four confirmed schizophrenia patients were allocated to receive ECT (n = 16) or MST (n = 18) over a 4-week period. Schizophrenia symptoms were measured by PANSS, cognition by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and serum BDNF and its precursor proBDNF by ELISA at baseline and following ECT or MST. Both treatments reduced PANSS scores with comparable efficacy, while MST was superior for preservation of RBANS language score. ECT significantly increased the volumes of the bilateral hippocampus and multiple subfields, while MST had no effect on hippocampal volume. The change in right hippocampal volume was correlated with proBDNF change among ECT and MST non-responders (< 25% decrease in PANSS score). MST reduced schizophrenia symptoms as effectively as ECT with slightly better preservation of cognitive function.
电抽搐治疗（ECT）可以有效地减轻精神分裂症的症状，但也可能损害认知功能。一种潜在的替代方法是磁惊厥治疗（MST），它具有相似的疗效，认知障碍较轻。本研究比较了 ECT 和 MST 的临床疗效和认知副作用。此外，我们还研究了海马体积变化和增强脑源性神经营养因子（BDNF）信号传导对治疗反应的可能贡献。34 名确诊的精神分裂症患者被分配接受 ECT（n=16）或 MST（n=18）治疗，为期 4 周。采用阳性和阴性症状量表（PANSS）评估精神分裂症症状，采用重复性成套神经心理状态测验（RBANS）评估认知功能，采用 ELISA 法检测血清 BDNF 和其前体 proBDNF，分别在基线时和 ECT 或 MST 治疗后进行。两种治疗方法均能降低 PANSS 评分，疗效相当，而 MST 则能更好地保护 RBANS 语言评分。ECT 显著增加了双侧海马体和多个亚区的体积，而 MST 对海马体体积没有影响。在 ECT 和 MST 无反应者（PANSS 评分下降<25%）中，右海马体体积的变化与 proBDNF 的变化相关。MST 与 ECT 一样有效地减轻了精神分裂症的症状，并且对认知功能的保护作用稍好。
