Effect of quantitative consciousness index on seizure parameters during electroconvulsive therapy in patients with major depressive disorder  

作　　者：Bang-Shu Zhao Bi Deng Qi-Bin Chen Xiao Li You Yang Su Min 

机构地区：[1]Department of Anesthesiology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China [2]Department of Anesthesiology,The First Clinical College of Chongqing Medical University,Chongqing 400016,China [3]Department of Psychiatry,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China

出　　处：《World Journal of Psychiatry》2024年第9期1375-1385,共11页世界精神病学杂志

基　　金：the National Natural Science Foundation of China,No.81873798 and No.81901377;Chongqing Science and Technology Bureau Under Grant,No.cstc2019jcyj-msxmX0839.

摘　　要：BACKGROUND Electroconvulsive therapy(ECT)is both an effective treatment for patients with major depressive disorder(MDD)and a noxious stimulus.Although some studies have explored the effect of sedation depth on seizure parameters in ECT,there is little research on the noxious stimulation response to ECT.In this study,we used two electroencephalography(EEG)-derived indices,the quantitative consci-ousness(qCON)index and quantitative nociceptive(qNOX)index,to monitor sedation,hypnosis,and noxious stimulation response in patients with MDD undergoing acute ECT.METHODS Patients with MDD(n=24)underwent acute bilateral temporal ECT under propofol anesthesia.Before ECT,the patients were randomly divided into three groups according to qCON scores(qCON60-70,qCON50-60,and qCON40-50).Continuous qCON monitoring was performed 3 minutes before and during ECT,and the qCON,qNOX,vital signs,EEG seizure parameters,and complications during the recovery period were recorded.The 24-item Hamilton Rating Scale for Depression,Zung’s Self-rating Depression Scale,and Montreal Cognitive Asse-ssment scores were evaluated before the first ECT session,after the fourth ECT session,and after the full course of ECT.RESULTS A total of 193 ECT sessions were performed on 24 participants.The qCON index significantly affected the EEG seizure duration,peak mid-ictal amplitude,and maximum heart rate during ECT(P<0.05).The qNOX index significantly affected the post-ictal suppression index(P<0.05).Age,number of ECT sessions,and anesthetic-ECT time intervals also had a significant effect on EEG seizure parameters(P<0.05).However,there were no significant differences in complications,24-item Hamilton Rating Scale for Depression scores,Zung’s Self-rating Depression Scale scores,or Montreal Cognitive Assessment scores among the three groups(P>0.05).CONCLUSION Electrical stimulation at a qCON index of 60-70 resulted in better EEG seizure parameters without increasing complications in patients with MDD undergoing bilateral temporal ECT under propofol anesthe

关 键 词：Electroconvulsive therapy PROPOFOL NOCICEPTION DEPRESSION ELECTROENCEPHALOGRAM 

分 类 号：R749.4[医药卫生—神经病学与精神病学]