ECT for Parkinson's disease

Article Abstract:

Parkinson's disease is characterized by neurological symptoms including tremor, muscular rigidity, and hypokinesia (abnormally reduced movement). One percent of persons over age 50 have Parkinson's disease, and two-thirds become severely disabled within the first ten years of the illness. Various treatments, including medication, surgery and electroconvulsive shock therapy, are reviewed. The drug levodopa prolongs life, but does not cure the disease. Levodopa has helped many patients, but is also linked to a very distressing aspect of Parkinson's disease known as the "on-off syndrome", in which patients alternate rapidly between dramatic relief of disability and profound paralysis. New surgical procedures are being developed that may prove beneficial. Scientists do not yet know the outcome of the first transplantation of fetal tissue into a Parkinson's disease patient's brain. Transplants of the patient's own adrenal tissue have not been as successful as early trials suggested; many patients developed serious medical complications. However, a promising treatment for Parkinson's disease may be found in electroconvulsive shock therapy (ECT). This technique was first used in Parkinson's disease patients who also had depression or mania (periods of extreme excitement) as a treatment for the depression or mania; their physicians were surprised to notice a clear improvement in motor abilities as well. Many separate studies have reported these effects; Parkinson's disease symptoms are typically improved for days or weeks. ECT appears to have fewer adverse effects on memory than levodopa or anticholinergic (which inhibit certain nerve impulses) medications and carries only minimal risk. All patients that do not respond well to drug therapy should receive ECT. Controlled research trials are greatly needed to investigate the potential benefits of ECT for Parkinson's disease patients.

Health aspects, Evaluation, Parkinsonism, Electric shock, Electric shock injuries, editorial, Antiparkinsonian agents, Antiparkinson agents

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Differential effects of right unilateral and bilateral ECT on heart rate

Article Abstract:

A study designed to describe the effects of right unilateral and bilateral electroconvulsive therapy (ECT) on heart rate was conducted using 11 patients with melancholia, a type of severe depression. All patients underwent both types of treatment. ECT involves the use of electric voltage to produce convulsions. It is still used in patients who fail to respond to less dramatic therapy or who suffer from specific types of mental illness, especially acute depression with suicidal tendencies. An increase in heart rate normally occurs during the course of this therapy and can be explained as a result of preanesthetic and anesthetic medications and the physiological result of the cerebral seizure that is induced. It is known that ECT to both sides of the body has a greater effect upon neuropsychological, clinical, EEG, and other parameters than right-sided ECT. Previous research indicates that a more complete intracerebral seizure occurs when bilateral seizure is induced than in the right unilateral ECT. Both types of seizures were induced in all 11 patients and the data that were analyzed included pre-stimulus heart rate, peak heart rate and other variables. The largest mean differences in heart rates were found in the time period from 40 to 120 seconds after the voltage was applied. Heart rates in the bilateral treatment of ECT were substantially higher than in the right unilateral ECT. In both tests the mean duration of the seizure was approximately 43 seconds. Overall, these findings reenforce prior studies that indicate that bilateral ECT has a greater physiological effect on patients than unilateral ECT, although the explanation for this has yet to be determined.

Analysis, Physiological aspects, Depression, Mental, Depression (Mood disorder), Comparative analysis, Heart beat, Heart rate, Electroconvulsive therapy, Electroshock, Electrotherapeutics

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The diagnostic implications of formal thought disorder in mania and schizophrenia: a reassessment

Article Abstract:

The authors compared three groups of patients: nine manic patients exhibiting formal thought disorders (tangentiality, neologisms, drivelling, private use of words, and paraphasias), 102 manic patients without these thought disorders and 31 schizophrenic patients. The first group tended to have more "schizophrenic" symptoms than did manic patients without formal thought disorders. During the study, both groups of manic patients showed greater improvement than the schizophrenic group. In mania, narrowly defined formal thought disorders were rare, whereas the flight of ideas was more common. A precise definition and description of thought disorders would help in distinguishing between mania and schizophrenia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Complications and side effects, Schizophrenia, Psychoses, Psychotic disorders

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