Coffey C E, Lucke J, Weiner R D, Krystal A D, Aque M
Department of Psychiatry (Neuropsychiatry), Medical College of Pennsylvania, Pittsburgh, USA.
Biol Psychiatry. 1995 May 15;37(10):713-20. doi: 10.1016/0006-3223(95)00262-F.
We measured initial seizure threshold by means of a structured stimulus dosage titration procedure in a clinical sample of 111 depressed patients undergoing brief-pulse, constant-current electroconvulsive therapy (ECT). Initial seizure threshold was approximately 60 millicoumbs (mc) (10 Joules) on average, but varied widely (6-fold) across patients. Initial seizure threshold was predicted by four variables: electrode placement (higher with bilateral), gender (higher in men), age (higher with increasing age), and dynamic impedance (inverse relationship). Use of neuroleptic medication was associated with a lower seizure threshold. EEG seizure duration was inversely related to initial seizure threshold, but no other relations with seizure duration were found. These findings may have important clinical implications for stimulus dosing strategies in ECT.
我们通过结构化刺激剂量滴定程序，对111名接受短脉冲、恒流电休克治疗（ECT）的抑郁症患者临床样本测量初始癫痫阈值。初始癫痫阈值平均约为60毫库仑（mc）（10焦耳），但患者之间差异很大（6倍）。初始癫痫阈值由四个变量预测：电极放置（双侧放置时较高）、性别（男性较高）、年龄（随年龄增长而升高）和动态阻抗（呈反比关系）。使用抗精神病药物与较低的癫痫阈值相关。脑电图癫痫持续时间与初始癫痫阈值呈负相关，但未发现与癫痫持续时间的其他关系。这些发现可能对ECT中的刺激剂量策略具有重要的临床意义。
