Safety and efficacy of electroconvulsive therapy for depression following cerebrovascular accident

Introduction: Depressive syndromes are common following cerebrovascular accident (CVA) and many patients do not respond to pharmacotherapy. Electroconvulsive therapy (ECT) is a safe and effective treatment for mood disorders arising with many comorbid medical conditions. In this paper, we describe the successful treatment of post-CVA depression with ECT.Methods: Retrospective chart review of 24 patients hospitalised for depression on an in-patient Medical Psychiatry unit between 2000 and 2010. Medical, neurologic and psychiatric histories, physical examination findings, results of laboratory, imaging and neurophysiologic investigations and treatment response with medications and ECT were recorded.Results: Twenty patients (83%) showed a positive response to treatment with ECT. None had worsening of depression after the ECT or experienced exacerbation of post-stroke neurological deficits. Three patients suffered from minor complications of ECT (prolonged confusion or short-term memory problems).Conclusions: This review supports the use of ECT after a stroke with appropriate clinical observation. The treatment was well tolerated and the majority obtained clinical benefit.

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Contralateral Interhemispheric Approach to Deep-Seated Cavernous Malformations

Neurosurgery ◽

10.1227/neu.0000000000000339 ◽

2014 ◽

Vol 75 (1) ◽

pp. 80-86 ◽

Cited By ~ 18

Author(s):

Hasan A. Zaidi ◽

Shakeel A. Chowdhry ◽

Peter Nakaji ◽

Adib A. Abla ◽

Robert F. Spetzler

Keyword(s):

Clinical Outcomes ◽

Chart Review ◽

Short Term Memory ◽

Demographic Data ◽

Retrospective Chart Review ◽

Senior Author ◽

Cavernous Malformations ◽

Memory Problems ◽

Interhemispheric Approach

Abstract BACKGROUND: Deep-seated periventricular cavernous malformations of the basal ganglia or thalamus can be approached via an interhemispheric craniotomy. OBJECTIVE: To determine surgical efficacy and clinical outcomes of the contralateral interhemispheric approach. METHODS: Retrospective chart review was performed on patients undergoing an interhemispheric approach for the resection of deep-seated cavernous malformation by the senior author (R.F.S.) between 2005 and 2013. Demographic data and clinical outcomes were reviewed. Pre- and postoperative imaging were analyzed for lesion location, size, associated venous anomaly, proximity to ventricle, and presence of residual. RESULTS: Twenty-one patients underwent a contralateral interhemispheric-transventricular approach, 7 patients had a contralateral interhemispheric-transcingulate approach and 3 patients had a contralateral interhemispheric-transchoroidal approach. Mean age was 40.1 years, and the majority were female (58.1%). Mean maximum cavernoma diameter was 1.97 cm, and 43.8% reached the surface of the ventricle. Average follow-up was 8.9 months, with complete resection achieved in 96.8% of patients. At last follow-up, 61.3% of patients remained stable and 29.0% had improved. Of the patients, 6.5% experienced transient weakness that resolved at last follow-up, and 1 patient (3.2%) had short-term memory problems. There were no surgical mortalities. CONCLUSION: The contralateral interhemispheric approach is a safe, clinically well tolerated, and surgically efficacious approach to deep-seated cavernomas.

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Electroconvulsive therapy hasn’t negative effects on short-term memory function, as assessed using a bedside hand-held device

Mental Illness ◽

10.4081/mi.2017.7093 ◽

2017 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Helge H.O. Müller ◽

Mareen Reike ◽

Simon Grosse-Holz ◽

Mareike Röther ◽

Caroline Lücke ◽

...

Keyword(s):

Cognitive Performance ◽

Electroconvulsive Therapy ◽

Short Term Memory ◽

Memory Function ◽

Memory Deficits ◽

Treatment Resistant ◽

Negative Effects ◽

Short Term ◽

Term Memory ◽

Digital Measurements

Electroconvulsive therapy (ECT) is effective in the treatment of treatment-resistant major depression. The fear of cognitive impairment after ECT often deters patients from choosing this treatment option. There is little reliable information regarding the effects of ECT on overall cognitive performance, while short-term memory deficits are well known but not easy to measure within clinical routines. In this pilot study, we examined ECT recipients’ pre- and posttreatment performances on a digital ascending number tapping test. We found that cognitive performance measures exhibited good reproducibility in individual patients and that ECT did not significantly alter cognitive performance up to 2 hours after this therapy was applied. Our results can help patients and physicians make decisions regarding the administration of ECT. Digital measurements are recommended, especially when screening for the most common side effects on cognitive performance and short-term memory.

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Two Independent Sources of Short Term Memory Problems during Sleep Deprivation

SLEEP ◽

10.5665/sleep.2696 ◽

2013 ◽

Author(s):

Adrienne M. Tucker

Keyword(s):

Sleep Deprivation ◽

Short Term Memory ◽

Short Term ◽

Term Memory ◽

Memory Problems

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A within-subject comparison of seizure duration with etomidate and methohexital in electroconvulsive therapy

10.7287/peerj.preprints.87 ◽

2013 ◽

Author(s):

Kevin J Black

Keyword(s):

Clinical Significance ◽

Electroconvulsive Therapy ◽

Chart Review ◽

Retrospective Chart Review ◽

The Other ◽

Seizure Duration ◽

Subject Comparison ◽

First Session

Objective: To determine whether etomidate is associated with longer seizures than methohexital in ECT anesthesia. Methods: Retrospective chart review in 39 patients who were switched from one anesthetic to the other. We compared motor and EEG seizure duration in the last ECT session on one anesthetic and the first session on the other anesthetic. Results: Motor seizures were about 10 seconds longer with etomidate (p < 0.05). However, few of the increases in seizure duration had obvious clinical import. Conclusions: Etomidate can lengthen ECT seizure time compared with methohexital, but the clinical significance of this observation requires further study.

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Maintenance Electroconvulsive Therapy and hospital re-admission days among patients with mental illness in Malaysia

10.1101/2020.09.20.20197079 ◽

2020 ◽

Author(s):

Benedict Francis ◽

Yit Han Ng ◽

Julian Joon Ip Wong ◽

Shiau Thin Ling ◽

Jesjeet Singh Gill ◽

...

Keyword(s):

Mental Illness ◽

Electroconvulsive Therapy ◽

Treatment Modality ◽

Affective Disorders ◽

Chart Review ◽

Retrospective Chart Review ◽

National Data ◽

Schizophrenia Spectrum ◽

Maintenance Ect ◽

Review Study

Abstract Background : Relapse prevention strategies are important as part of optimal patient care. As such, maintenance electroconvulsive therapy (mECT) is an important treatment modality to keep patients in remission longer. Aims : Our study aimed to explore the characteristics of patients receiving maintenance ECT (mECT) and further investigate whether this treatment modality reduces re-admission days in patients with severe mental illness. Methods : A retrospective chart review study design was employed. The medical records of 22 patients followed up at University Malaya Medical centre, were analysed with regards to the outcome measures, which was days of re-admission post mECT, Potential confounders were controlled for via stratification analysis. Results : There was a significant reduction in re-admission days post mECT (p<0.001, r:0.85 ) across all the variables analysed. The variable with the biggest effect size were patients younger than 60 years old (p:0.01, r:0.70), followed by medication with polypharmacy (p:0.002, r: 0.65). The magnitude of reduction in re-admissions was greater in the schizophrenia spectrum group compared to the affective disorders group (r: 0.64 vs. 0.57). Conclusion : Our study provides national data regarding the efficacy of mECT in significantly reducing days of re-admission in patients with treatment resistant schizophrenia spectrum illness and affective disorders. As widespread usage of mECT is still lacking in Asia, our results is encouraging for more practitioners to prescribe mECT for their patients.

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Psychosocial Outcomes following Electroconvulsive Therapy in a Community Setting: Retrospective Chart Review with 2-Year Follow-up

The Canadian Journal of Psychiatry ◽

10.1177/070674370705200908 ◽

2007 ◽

Vol 52 (9) ◽

pp. 598-604 ◽

Cited By ~ 3

Author(s):

Biju Mathew ◽

Marliese Y Dawson ◽

Chris Kozanitis ◽

Britt Bright ◽

HV Gopinath ◽

...

Keyword(s):

Mood Disorders ◽

Electroconvulsive Therapy ◽

Psychosocial Functioning ◽

Chart Review ◽

Community Hospital ◽

Retrospective Chart Review ◽

Psychosocial Outcomes ◽

Open Label ◽

Meaningful Improvement

Objective: Electroconvulsive therapy (ECT) continues to be one of the most effective biological therapies for patients with mood disorders. Numerous studies address clinical response; however, few have examined psychosocial or occupational outcomes following ECT, especially in community settings. This study aimed to examine these outcomes in short- and long-term naturalistic follow-up of ECT conducted in a community hospital. Methods: A retrospective chart review was conducted of all patients who received ECT at Ridge Meadows Hospital in Maple Ridge, British Columbia, between January 1997 and December 2003. Charts were evaluated with the Clinical Global Impression (CGI), Global Assessment of Functioning, and Social and Occupational Functioning Assessment Scales prior to ECT and at 6 months, 1 year, and 2 years post-ECT. Results: A total of 90 patients with mood disorders underwent ECT; 86.5% were rated on the CGI as “markedly ill” to “among the most extremely ill” at baseline. All clinical ratings improved at every follow-up point, and by the end of 24 months, 56.6% of patients were rated as “much improved” or “very much improved” on the CGI. Similarly, the measures of psychosocial functioning also showed significant improvement throughout the follow-up period. Conclusions: These findings show that substantial and meaningful improvement occurred in clinical and psychosocial outcomes after ECT conducted in a community hospital. These changes were robust and stable over the 2-year follow-up period. Limitations of the study include the retrospective ratings, the open-label use of ECT, and the naturalistic treatment in follow-up.

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Rebleeding risk after treatment of ruptured intracranial aneurysms

Journal of Neurosurgery ◽

10.3171/2011.1.jns101232 ◽

2011 ◽

Vol 114 (6) ◽

pp. 1778-1784 ◽

Cited By ~ 16

Author(s):

J. Brett Fleming ◽

Brian L. Hoh ◽

Scott D. Simon ◽

Babu G. Welch ◽

Robert A. Mericle ◽

...

Keyword(s):

Endovascular Treatment ◽

Intracranial Aneurysms ◽

Large Scale ◽

Chart Review ◽

Cerebral Aneurysms ◽

Retrospective Chart Review ◽

Short Term ◽

International Subarachnoid Aneurysm Trial ◽

Rebleeding Rate ◽

Ruptured Intracranial Aneurysms

Object Postprocedural rebleeding is a significant source of morbidity following endovascular treatment of ruptured intracranial aneurysms. Previous large-scale reports include the Cerebral Aneurysm Rerupture After Treatment trial, the International Subarachnoid Aneurysm Trial, and the study on Early Rebleeding after Coiling of Ruptured Cerebral Aneurysms, which reported nonprocedural rebleeding rates within 30 days of treatment of 2.7%, 1.9%, and 1.4%, respectively. However, coiling of intracranial aneurysms is in a state of continual change due to advancing device design and evolving techniques. These studies included only patients initially treated prior to 2004. In the present study the authors assess the most recent short-term results with endovascular treatment of ruptured aneurysms. Methods A multicenter retrospective chart review was conducted of patients undergoing endovascular treatment for ruptured intracranial aneurysms between July 2004 and October 2009. The technique used, including the use of stent or balloon assistance, was evaluated. Demographic and clinical factors, such as sex, age, initial clinical presentation, aneurysm size, aneurysm location, and modified Raymond Classification following initial treatment, were also evaluated and compared between the groups in which rebleeding did and did not occur. Results A total of 469 patients underwent endovascular treatment for a ruptured aneurysm; nonprocedural rehemorrhage occurred within 30 days of the initial coiling in 4 cases (0.9%). Two patients (50%) died after rehemorrhage. Stent-assisted coiling was used during the original treatment in 1 (25%) of the 4 patients with a rerupture. However, no technical, clinical, or demographic factors were found to be statistically significant in association with rebleeding. Conclusions Recent data suggest that the periprocedural rebleeding rate may be improving over time.

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Electroconvulsive therapy hasn't negative effects on short-term memory function, as assessed using a bedside hand-held device

Mental Illness ◽

10.1108/mi.2017.7093 ◽

2017 ◽

Vol 9 (1) ◽

pp. 30-35 ◽

Cited By ~ 1

Author(s):

Helge H.O. Müller ◽

Mareen Reike ◽

Simon Grosse-Holz ◽

Mareike Röther ◽

Caroline Lücke ◽

...

Keyword(s):

Cognitive Performance ◽

Electroconvulsive Therapy ◽

Short Term Memory ◽

Memory Function ◽

Memory Deficits ◽

Treatment Resistant ◽

Negative Effects ◽

Short Term ◽

Term Memory ◽

Digital Measurements

Electroconvulsive therapy (ECT) is effective in the treatment of treatment-resistant major depression. The fear of cognitive impairment after ECT often deters patients from choosing this treatment option. There is little reliable information regarding the effects of ECT on overall cognitive performance, while short-term memory deficits are well known but not easy to measure within clinical routines. In this pilot study, we examined ECT recipients' pre- and post-treatment performances on a digital ascending number tapping test. We found that cognitive performance measures exhibited good reproducibility in individual patients and that ECT did not significantly alter cognitive performance up to 2 hours after this therapy was applied. Our results can help patients and physicians make decisions regarding the administration of ECT. Digital measurements are recommended, especially when screening for the most common side effects on cognitive performance and short-term memory.

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Impact of COVID-19 pandemic on breast surgery and breast reconstruction in a Japanese university hospital setting.

10.21203/rs.3.rs-88272/v1 ◽

2020 ◽

Author(s):

Dai Shibata ◽

Takahiko Kawate ◽

Takako Komiya ◽

Itaru Nakamura ◽

Takashi Ishikawa ◽

...

Keyword(s):

Breast Cancer ◽

Breast Reconstruction ◽

Chart Review ◽

Breast Surgery ◽

Hospital Setting ◽

Retrospective Chart Review ◽

University Hospital ◽

Breast Cancer Surgery ◽

Short Term ◽

Japanese University

Abstract The new coronavirus disease (COVID-19) is spreading worldwide. In Japan, the number of people infected has been increasing since March 2020. The COVID-19 pandemic has had a significant impact on hospitals, although Tokyo, Japan did not experience a collapse of the medical system. Patients were triaged and prioritized due to surgical limitations during the pandemic period. The purpose of this study was to determine how patients with breast cancer or breast reconstruction were affected by the COVID-19 pandemic at a university hospital in Tokyo. In this retrospective chart review we investigated how patients were treated, including surgical postponements during three periods: April to July 2020, August to November 2019 (after the Allergan recall), and April to July 2019. More than half of breast surgeries and breast reconstructions had to be postponed during the COVID-19 pandemic, and the number of candidates for surgery was also lower compared to the pre-pandemic periods. Triage of patients with breast cancer did not result in any adverse oncological outcomes for these patients. COVID-19 has had a major impact on breast cancer surgery and breast reconstruction, and there was substantial postponement of surgery. Due to triage and prioritization, no patients experienced disease progression in the short-term period, demonstrating that our strategy was appropriate.

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