Summary: | 碩士 === 高雄醫學大學 === 醫學系神經學科碩士班 === 97 === Background:Electroconvulsive therapy(ECT) is an established effective treatment modality for patients with severe depression. Several variables have been suggested that can predict the efficacy of ECT in patients suffering from depression. The aim of this study is to create an index of EEG and clinical findings for the prediction the response of ECT.
Methods:20 depressive patients referred for ECT were included. Poor response was defined as a decrease in Hamilton Rating Depression Scale less than 50%. Informations were gathered for predictors including sex, age, duration of index episode, seizure duration clinically and electrophysiologically, EEG variables & postictal suppression. ECT was given third times per week from April 2007 to Oct. 2008; The 17-item Hamilton Rating Scale for depression (HAM-D-17) was applied at baseline and weekly during the course.
Results:In this prospective study, decrease at least 50% in Hamilton Depression Scale (17 items) was considered as effective outcome. Twelve patients (60.0%) remitted. Comparison between responders & nonresponders, it shows significant differences with respect to HAM2, HAM3, Seizure duration at week 2, spike & wave phase duration at week 2, postictal suppression at week1, week2, week3. Forward stepwise logistic regcssion analysis selected only degree of postictal suppression at week 3 as a significant predictor for ECT efficacy.
Conclusion:Degree of postictal suppression was the best significant variable found to predict the efficacy of ECT
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