AFFECTIVE AND COGNITIVE CONSEQUENCES OF ECT

ECT 的情感和认知后果

• 批准号: 3375720
• 负责人: SIDNEY MALITZ
• 金额: $ 37.33万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 1981
• 资助国家: 美国
• 起止时间: 1981-12-01 至 1987-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3375720
• 关键词: antidepressants; brain interhemispheric activity; cognition disorders; dosage; electroconvulsive therapy; gender difference; human subject; human therapy evaluation; mental disorder chemotherapy; neural information processing; neuropsychology; nortriptyline; remission /regression

Two studies are proposed. The first study concerns the affective and cognitive consequences of ECT in 160 patients presenting primary, major depressive disorder. Patients will be randomly assigned to four ECT treatment conditions, crossing the factors of low and high ECT dosage and modality (unilateral right and bilateral electrode placements). Treatment responders will enter a double-blind drug continuation trail, contrasting nortriptyline and placebo. At pretreatment, postsixth ECT, posttreatment and 2-month followup a battery of clinical neuropsychological, neurophysiological, and neuroendocrinological procedures will be administered. Acute cognitive effects will also be examined at each treatment. Normal controls will be tested on major portions of the battery. The primary aims are (1) to determine dose/response relations as a function of modality for the affective and cognitive consequences of ECT (2) to identify pretreatment lateralized abnormalities in depressives and the effects of treatment conditions on such abnormalities (3) to determine the risk/benefits of postECT continuation medication in patients largely medication resistant during the acute phase of illness. The second study concerns the treatment of acute manic episodes. Patients (n=120) will be randomly assigned to intensive pharmacotherapy with combination lithium/neuroleptic treatment or to unilateral left, unilateral right, or bilateral ECT conditions, after establishing resistence to preentry pharmacotherapy. Treatment responders will enter a double-blind comparison of low (0.5-0.7mEq/L) and high (0.8-1.OmEq/L) lithium continuation/maintenance therapy. The primary aims are (1) to determine rates of therapeutic response to the four acute treatments conditions, with the hypothesis that the ECT conditions will be more efficacious than intensive pharmacotherapy and that among the ECT conditions, left and bilateral ECT will be superior in efficacy to unilateral right ECT, (2) to identify neurophysiological abnormalities in regional cerebral blood flow and brain electrical activity in acute manic episodes and the effects of treatment conditions on such abnormalities, (3) to contrast low and high dosage lithium conditions with respect to quality of remission and rates of relapse/recurrence.

提出了两项​​研究。 第一项研究涉及情感和 ECT的认知后果在160名患者中 抑郁症。 患者将被随机分配给四个ECT 治疗条件，跨越低和高剂量的因素以及 模态（单侧右侧和双侧电极放置）。 治疗 响应者将进入双盲毒品延续步道，对比 Nortriptyline和安慰剂。 在预处理，后定位，治疗后治疗 和2个月的随访临床神经心理学， 神经生理学和神经内分泌程序将是 管理。 每个人还将检查急性认知效应 治疗。 正常控件将在大部分的主要部分进行测试 电池。 主要目的是（1）确定剂量/反应关系 ECT的情感和认知后果的模态函数 （2）确定抑郁剂和 治疗条件对这种异常的影响（3）确定 PESTECT继续药物对患者的风险/益处很大程度上 疾病的急性阶段耐药性。 第二项研究涉及急性躁狂发作的治疗。 患者 （n = 120）将随机分配给与 锂/神经治疗的组合或单侧单侧 在建立抵抗力之后，正确或双边ect条件 前药物治疗。 治疗响应者将进入双盲 低（0.5-0.7meq/l）和高（0.8-1.omeq/l）锂的比较 继续/维护疗法。 主要目的是（1）确定 对四种急性治疗条件的治疗率， ECT条件将比 强化药物疗法以及在ECT条件下，左和 双侧ECT的功效将优于单侧右ECT，（2） 鉴定区域脑血流中的神经生理异常 急性躁狂发作中的大脑电活动以及 这种异常的治疗条件，（3）对比度低和高 剂量锂条件相对于缓解质量和速率 复发/复发。