Coffey C E, Lucke J, Weiner R D, Krystal A D, Aque M
Department of Psychiatry (Neuropsychiatry), Medical College of Pennsylvania, Allegheny Campus, Pittsburgh, USA.
Biol Psychiatry. 1995 Jun 1;37(11):777-88. doi: 10.1016/0006-3223(95)00053-J.
To measure the anticonvulsant effects of a course of electroconvulsive therapy (ECT), we used a flexible stimulus dosage titration procedure to estimate seizure threshold at the first and sixth ECT treatments in 62 patients with depression who were undergoing a course of brief pulse, constant current ECT given at moderately suprathreshold stimulus intensity. Seizure threshold increased by approximately 47% on average, but only 35 (56%) of the 62 patients showed a rise in seizure threshold. The rise in seizure threshold was associated with increasing age, but not with gender, stimulus electrode placement, or initial seizure threshold. Dynamic impedance decreased by approximately 5% from the first to the sixth ECT treatment, but there was no correlation between the change in dynamic impedance and the rise in seizure threshold. No relation was found between the rise in seizure threshold and either therapeutic response status or speed of response to the ECT treatment course. These findings confirm the anticonvulsant effect of ECT but suggest that such effects are not tightly coupled to the therapeutic efficacy of moderately suprathreshold ECT.
为了测量一个疗程的电休克治疗（ECT）的抗惊厥效果，我们采用了灵活的刺激剂量滴定程序，在62名接受短暂脉冲、恒流ECT治疗且刺激强度适度高于阈值的抑郁症患者中，估计首次和第六次ECT治疗时的癫痫发作阈值。癫痫发作阈值平均升高了约47%，但62名患者中只有35名（56%）的癫痫发作阈值有所升高。癫痫发作阈值的升高与年龄增长有关，但与性别、刺激电极放置位置或初始癫痫发作阈值无关。从首次ECT治疗到第六次ECT治疗，动态阻抗下降了约5%，但动态阻抗的变化与癫痫发作阈值的升高之间没有相关性。未发现癫痫发作阈值的升高与治疗反应状态或对ECT治疗疗程的反应速度之间存在关联。这些发现证实了ECT的抗惊厥作用，但表明这种作用与适度高于阈值的ECT的治疗效果没有紧密联系。
