Jiang Jiangling, Li Jin, Xu Yuanhong, Zhang Bin, Sheng Jianhua, Liu Dengtang, Wang Wenzheng, Yang Fuzhong, Guo Xiaoyun, Li Qingwei, Zhang Tianhong, Tang Yingying, Jia Yuping, Wang Jijun, Li Chunbo
Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu, China.
From the Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J ECT. 2025 Mar 1;41(1):55-61. doi: 10.1097/YCT.0000000000001047. Epub 2024 Aug 21.
A seizure lasting >15 s has been considered to indicate treatment for magnetic seizure therapy (MST), a modification of electroconvulsive therapy (ECT), without much validation. This study aimed to investigate whether this seizure duration was suitable for the treatment of schizophrenia.
Altogether, 34 and 33 in-patients with schizophrenia received 10 sessions of MST and ECT, respectively. Clinical symptoms were assessed using the Positive and Negative Symptom Scale at baseline and at the 4-week follow-up. Electroencephalogram (EEG) was monitored during each MST or ECT treatment using bifrontal electrodes.
The proportion of participants who achieved the 15-second threshold was only 28.6% in the MST group, with a significant difference between responders and nonresponders. For patients receiving MST, the average EEG seizure duration correlated with the percentage of Positive and Negative Symptom Scale reduction ( t(32) = 2.51, P = 0.017, uncorrected; t(32) = 2.00, P = 0.055, corrected with clinical characteristics). The average EEG seizure duration predicted the clinical response at a trend level ( Z = 1.76, P = 0.078) with an optimal cutoff of 11.3 seconds. All patients in the ECT group achieved the 15-second threshold. However, their average EEG seizure duration was uncorrelated with clinical improvement.
The duration of EEG seizures may be associated with the antipsychotic effects of MST. This association may have been influenced by various clinical and technical factors. More research is needed to define the specific criteria for adequate MST in schizophrenia in order to achieve personalized dosing.
持续超过15秒的癫痫发作被认为是磁休克治疗（MST，电休克治疗（ECT）的一种改良方式）的治疗指征，但缺乏充分验证。本研究旨在调查该癫痫发作持续时间是否适用于精神分裂症的治疗。
共有34例和33例精神分裂症住院患者分别接受了10次MST和ECT治疗。在基线和4周随访时使用阳性和阴性症状量表评估临床症状。在每次MST或ECT治疗期间使用双额电极监测脑电图（EEG）。
MST组达到15秒阈值的参与者比例仅为28.6%，反应者和无反应者之间存在显著差异。对于接受MST治疗的患者，平均EEG癫痫发作持续时间与阳性和阴性症状量表降低的百分比相关（t(32)=2.51，P=0.017，未校正；t(32)=2.00，P=0.055，经临床特征校正）。平均EEG癫痫发作持续时间在趋势水平上预测了临床反应（Z=1.76，P=0.078），最佳截断值为11.3秒。ECT组所有患者均达到15秒阈值。然而，他们的平均EEG癫痫发作持续时间与临床改善无关。
EEG癫痫发作的持续时间可能与MST的抗精神病作用相关。这种关联可能受到各种临床和技术因素的影响。需要更多研究来确定精神分裂症中充分的MST的具体标准，以实现个性化给药。
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