AFFECTIVE AND COGNITIVE CONSEQUENCES OF ECT

ECT 的情感和认知后果

• 批准号: 3375721
• 负责人: HAROLD A. SACKEIM
• 金额: $ 13.42万
• 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: 1988
• 资助国家: 美国
• 起止时间: 1988-08-01 至 1990-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3375721
• 关键词: antidepressants; bipolar depression manic phase; brain interhemispheric activity; cognition disorders; combination chemotherapy; dosage; electroconvulsive therapy; electroencephalography; gender difference; human subject; human therapy evaluation; lithium; major depression; mental disorder chemotherapy; neuropsychological tests; neuropsychology; nortriptyline; remission /regression; tranquilizer

Two studies are proposed and both involve continuation of ongoing work. The first study concerns the affective and cognitive consequences of ECT in 100 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 enter a double-blind drug continuation trial, contrasting nortriptyline and placebo. At pretreatment, postsixth ECT, posttreatment and 2-month followup a battery of neuropsychological, neurophysiological, and neuroendocrinological procedures will be administered. Acute cognitive effects will 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 neuropsychological and neurophysiological abnormalities in depressed patients and the effects of treatment conditions on such abnormalities; (3) to evaluate a new method of ECT administration and to better characterize the nature and effects of electrical stimulation; (4) 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=75) will be randomly assigned to intensive pharmacotherapy with combination lithium/neuroleptic treatment or to unilateral left, unilateral right, or bilateral ECT conditions, after establishing resistance to preentry pharmacotherapy. The primary aims are (1) to determine rates of therapeutic response to the four acute treatment conditions, with the hypothesis that among the ECT conditions, left and bilateral ECT will be superior in efficacy to unilateral right ECT; (2) to identify neurophysiological and biochemical abnormalities in regional cerebral blood flow and brain electrical activity in acute manic episodes and the effects of treatment conditions on such abnormalities.

提出了两项​​研究，并且都涉及持续的继续 工作。 第一项研究涉及情感和认知 ECT在100名患者中的ECT产生的后果 抑郁症。 患者将被随机分配到四个 ECT处理条件，越过低和高ECT的因素 剂量和方式（单侧右侧和双侧电极 位置）。 治疗响应者进入双盲药物 继续试验，对比北替林线和安慰剂。 在 预处理，后电位，治疗后和2个月的随访 神经心理学，神经生理学和 将采用神经内分泌程序。 急性 在每种治疗中将检查认知效应。 普通的 控件将在电池的主要部分进行测试。 这 主要目的是（1）确定剂量/反应关系 情感和认知后果的方式的功能 ect; （2）确定预处理神经心理学和 抑郁症患者的神经生理异常和 治疗条件对这种异常的影响； （3）到 评估一种新的ECT管理方法和更好 表征电刺激的性质和影响； （4） 确定PESTECT延续药物的风险/好处 在患者中，在很大程度上耐药的急性阶段 疾病。 第二项研究涉及急性躁狂发作的治疗。 患者（n = 75）将随机分配给密集型 结合锂/神经摄影治疗的药物治疗或 左，单侧右或双侧ECT条件， 在建立了对术前药物疗法的抗性之后。 这 主要目的是（1）确定对治疗率 四个急性治疗条件，假设 ECT条件，左侧和双侧ECT在 单方面权利的功效； （2）识别 区域性的神经生理和生化异常 急性躁狂的脑血流和脑电活动 发作和治疗条件对此类的影响 异常。