Research advances of modified electroconvulsive therapy for first-episode schizophrenia

doi:10.3969/j.issn.1006-7795.2022.02.015

Abstract

Abstract: As one of the commonly used physical therapy methods in clinical practice, modified electroconvulsive therapy (MECT) is currently recommended for patients with acute exacerbations of positive symptoms or catatonia. First-episode schizophrenia (FES) usually begins in adolescence or early adulthood, and the prognosis of FES is crucial to the shaping of the patient's personality and the maintenance of social relationships in the later period. Starting from the mechanism of action, this paper summarized the research progresses in the MECT for FES and found that MECT not only takes effect quickly but also shows long-term therapeutic effect in the maintenance period, with good safety. However, there are not enough studies on MECT treatment for FES at present, and the overall quality of the included studies is plain. The reliability of the conclusions needs to be confirmed by multi-center and large sample randomized controlled studies.

Key words: modified electroconvulsive therapy, first-episode schizophrenia, efficacy, safety, mechanism

CLC Number:

R749.3

Li li, Liu Chaomeng, Ren Yanping, Yang Chunlin, Ma Xin. Research advances of modified electroconvulsive therapy for first-episode schizophrenia[J]. Journal of Capital Medical University, 2022, 43(2): 249-253.

References

[1] Huang Y Q, Wang Y, Wang H, et al. Prevalence of mental disorders in China: a cross-sectional epidemiological study[J]. Lancet Psychiatry, 2019, 6(3): 211-224.
[2] McCutcheon R A, Reis Marques T, Howes O D. Schizophrenia-an overview[J]. JAMA Psychiatry, 2020, 77(2): 201-210.
[3] Grover S, Sahoo S, Rabha A, et al. ECT in schizophrenia: a review of the evidence[J]. Acta Neuropsychiatr, 2019, 31(3): 115-127.
[4] Galderisi S, Davidson M, Kahn R S, et al. Correlates of cognitive impairment in first episode schizophrenia: The EUFEST study[J]. Schizophr Res, 2009, 115(2/3): 104-114.
[5] Barnes T R, Hutton S B, Chapman M J, et al. West London first-episode study of schizophrenia. Clinical correlates of duration of untreated psychosis[J]. Br J Psychiatry, 2000, 177: 207-211.
[6] Lava-Parmele S, Lava C, Parmele J B. The historical struggles of modified electroconvulsive therapy: how anesthesia came to the rescue[J]. J Anesth Hist, 2021, 7(2): 17-25.
[7] Pal R, Pal V S. Anesthesia for electroconvulsive therapy: a noble approach[J]. Int J Med Res Health Sci, 2015, 4(4): 890.
[8] Maley C T, Becker J E, Shultz E K B. Electroconvulsive therapy and other neuromodulation techniques for the treatment of psychosis[J]. Child Adolesc Psychiatr Clin N Am, 2019, 28(1): 91-100.
[9] Ali S A, Mathur N, Malhotra A K, et al. Electroconvulsive therapy and schizophrenia: a systematic review[J]. Mol Neuropsychiatry, 2019, 5(2): 75-83.
[10] Fink M, Sackeim H A. Convulsive therapy in schizophrenia?[J]. Schizophr Bull, 1996, 22(1): 27-39.
[11] Suzuki K, Awata S, Takano T, et al. Improvement of psychiatric symptoms after electroconvulsive therapy in young adults with intractable first-episode schizophrenia and schizophreniform disorder[J]. Tohoku J Exp Med, 2006, 210(3): 213-220.
[12] Mohapatra S, Rath N. Electroconvulsive therapy in a child suffering from acute and transient psychotic disorder with catatonic features[J]. Indian J Psychol Med, 2015, 37(4): 465-466.
[13] Flamarique I, Castro-Fornieles J, Garrido J M, et al. Electroconvulsive therapy and clozapine in adolescents with schizophrenia spectrum disorders: is it a safe and effective combination?[J]. J Clin Psychopharmacol, 2012, 32(6): 756-766.
[14] 孙婉娇, 黄永清. 改良电休克在精神分裂症临床治疗中的应用进展[J]. 医学综述, 2020, 26(4): 729-732, 737.
[15] Baeza I, Flamarique I, Garrido J M, et al. Clinical experience using electroconvulsive therapy in adolescents with schizophrenia spectrum disorders[J]. J Child Adolesc Psychopharmacol, 2010, 20(3): 205-209.
[16] De La Serna E, Flamarique I, Castro-Fornieles J, et al. Two-year follow-up of cognitive functions in schizophrenia spectrum disorders of adolescent patients treated with electroconvulsive therapy[J]. J Child Adolesc Psychopharmacol, 2011, 21(6): 611-619.
[17] Flamarique I, Baeza I, De La Serna E, et al. Long-term effectiveness of electroconvulsive therapy in adolescents with schizophrenia spectrum disorders[J]. Eur Child Adolesc Psychiatry, 2015, 24(5): 517-524.
[18] Adhikari S R. Electroconvulsive therapy in first episode schizophrenia-experiences from Nepal[J]. J Psychiatrists' Association of Nepal, 2014, 3(1): 35-40.
[19] 陈红玉, 程万清, 李世朝, 等. 多功能无抽搐电休克联合舍曲林治疗精神分裂症后抑郁[J]. 湖北医药学院学报, 2018, 37(4): 334-337.
[20] 刘毅, 任艳萍, 姜玮, 等. 基于神经心理与生理学评估的精神分裂症无抽搐电休克治疗后认知功能的研究[J]. 首都医科大学学报, 2018, 39(5): 651-656.
[21] Zheng W, Tong G, Ungvari G S, et al. Memory impairment following electroconvulsive therapy in Chinese patients with schizophrenia: Meta-analysis of randomized controlled trials[J]. Perspect Psychiatr Care, 2018, 54(2): 107-114.
[22] Mora F, Segovia G, Del Arco A. Aging, plasticity and environmental enrichment: structural changes and neurotransmitter dynamics in several areas of the brain[J]. Brain Res Rev, 2007, 55(1): 78-88.
[23] Doongaji D R, Jeste D V, Saoji N J, et al. Unilateral versus bilateral ECT in schizophrenia[J]. Br J Psychiatry, 1973, 123(572): 73-79.
[24] Phutane V H, Thirthalli J, Muralidharan K, et al. Double-blind randomized controlled study showing symptomatic and cognitive superiority of bifrontal over bitemporal electrode placement during electroconvulsive therapy for schizophrenia[J]. Brain Stimul, 2013, 6(2): 210-217.
[25] Kantrowitz J T. Targeting serotonin 5-HT_2A receptors to better treat schizophrenia: rationale and current approaches[J]. CNS Drugs, 2020, 34(9): 947-959.
[26] Kishimoto T, Hagi K, Nitta M, et al. Long-term effectiveness of oral second-generation antipsychotics in patients with schizophrenia and related disorders: a systematic review and meta-analysis of direct head-to-head comparisons[J]. World Psychiatry, 2019, 18(2): 208-224.
[27] Cooper S J, Leahey W, Green D F, et al. The effect of electroconvulsive therapy on CSF amine metabolites in schizophrenic patients[J]. Br J Psychiatry, 1988, 152: 59-63.
[28] Saijo T, Takano A, Suhara T, et al. Electroconvulsive therapy decreases dopamine D2receptor binding in the anterior cingulate in patients with depression: a controlled study using positron emission tomography with radioligand [¹¹C] FLB 457[J]. J Clin Psychiatry, 2010, 71(6): 793-799.
[29] Shapira B, Lerer B, Kindler S, et al. Enhanced serotonergic responsivity following electroconvulsive therapy in patients with major depression[J]. Br J Psychiatry, 1992, 160: 223-229.
[30] Yatham L N, Liddle P F, Lam R W, et al. Effect of electroconvulsive therapy on brain 5-HT(2) receptors in major depression[J]. Br J Psychiatry, 2010, 196(6): 474-479.
[31] Khandaker G M, Dantzer R, Jones P B. Immunopsychiatry: important facts[J]. Psychol Med, 2017, 47(13): 2229-2237.
[32] Miller B J, Buckley P, Seabolt W, et al. Meta-analysis of cytokine alterations in schizophrenia: clinical status and antipsychotic effects[J]. Biol Psychiatry, 2011, 70(7): 663-671.
[33] Fluitman S B A H A, Heijnen C J, Denys D A J P, et al. Electroconvulsive therapy has acute immunological and neuroendocrine effects in patients with major depressive disorder[J]. J Affect Disord, 2011, 131(1/3): 388-392.
[34] Chaturvedi S, Chadda R K, Rusia U, et al. Effect of electroconvulsive therapy on hematological parameters[J]. Psychiatry Res, 2001, 104(3): 265-268.
[35] Fatemi S H, Folsom T D. The neurodevelopmental hypothesis of schizophrenia, revisited[J]. Schizophr Bull, 2009, 35(3): 528-548.
[36] Xu H, Wang J S, Zhou Y J, et al. BDNF affects the mediating effect of negative symptoms on the relationship between age of onset and cognition in patients with chronic schizophrenia[J]. Psychoneuroendocrinology, 2021, 125: 105121.
[37] Madsen T M, Treschow A, Bengzon J, et al. Increased neurogenesis in a model of electroconvulsive therapy[J]. Biol Psychiatry, 2000, 47(12): 1043-1049.
[38] Pandya C D, Kutiyanawalla A, Pillai A. BDNF-TrkB signaling and neuroprotection in schizophrenia[J]. Asian J Psychiatr, 2013, 6(1): 22-28.
[39] Martinotti G, Ricci V, Di Nicola M, et al. Brain-derived neurotrophic factor and electroconvulsive therapy in a schizophrenic patient with treatment-resistant paranoid-hallucinatory symptoms[J]. J ECT, 2011, 27(1): e44-e46.
[40] Fernandes B S, Massuda R, Torres M, et al. Improvement of schizophrenia with electroconvulsive therapy and serum brain-derived neurotrophic factor levels: lack of association in a pilot study[J]. Psychiatry Clin Neurosci, 2010, 64(6): 663-665.
[41] Flatow J, Buckley P, Miller B J. Meta-analysis of oxidative stress in schizophrenia[J]. Biol Psychiatry, 2013, 74(6): 400-409.
[42] Kartalci S, Karabulut A B, Ozcan A C, et al. Acute and chronic effects of electroconvulsive treatment on oxidative parameters in schizophrenia patients[J]. Prog Neuropsychopharmacol Biol Psychiatry, 2011, 35(7): 1689-1694.
[43] Rosenquist P B, Miller B, Pillai A. The antipsychotic effects of ECT: a review of possible mechanisms[J]. J ECT, 2014, 30(2): 125-131.
[44] Andrade C, Bolwig T G. Electroconvulsive therapy, hypertensive surge, blood-brain barrier breach, and amnesia: exploring the evidence for a connection[J]. J ECT, 2014, 30(2): 160-164.
[45] De Jong J O Z, Arts B, Boks M P, et al. Epigenetic effects of electroconvulsive seizures[J]. J ECT, 2014, 30(2): 152-159.