Prudic J, Sackeim H A, Devanand D P, Krueger R B, Settembrino J M
Department of Biological Psychiatry, New York State Psychiatric Institute, New York 10032.
Convuls Ther. 1994 Mar;10(1):4-24.
Empirical titration procedures increasingly are being used to estimate initial seizure threshold. These procedures involve the administration of subconvulsive electrical stimulation. There has yet to be evaluation of the impact of such stimulation on the acute cognitive consequences of electroconvulsive therapy. In two studies we randomized depressed patients to right unilateral or bilateral ECT, with stimulus intensity maintained just above seizure threshold throughout the treatment course. These low dosage treatment groups received one or more subconvulsive stimuli in approximately 40% of treatment sessions, with a grand mal seizure also elicited at each session. Extensive neuropsychological evaluation was conducted at each session. We contrasted treatment sessions in which generalized seizures were preceded by subconvulsive stimulation with treatment sessions in which a single convulsive stimulation was applied. Across a variety of neuropsychological measures, there were no adverse cognitive consequences of subconvulsive stimulation.
经验性滴定程序越来越多地被用于估计初始癫痫阈值。这些程序涉及给予亚惊厥性电刺激。然而，尚未评估这种刺激对电休克治疗急性认知后果的影响。在两项研究中，我们将抑郁症患者随机分为右侧单侧或双侧电休克治疗组，在整个治疗过程中，刺激强度维持在刚好高于癫痫阈值的水平。这些低剂量治疗组在约40%的治疗疗程中接受一次或多次亚惊厥性刺激，每次疗程也会引发一次大发作。在每个疗程都进行了广泛的神经心理学评估。我们将在全身性癫痫发作之前有亚惊厥性刺激的治疗疗程与仅应用一次惊厥性刺激的治疗疗程进行了对比。在各种神经心理学测量中，亚惊厥性刺激没有不良认知后果。
