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Efficacy of Electroconvulsive Therapy for the Treatment of Movement Disorders: A Literature Review. Cureus 2023; 15:e36634. [PMID: 36968685 PMCID: PMC10038173 DOI: 10.7759/cureus.36634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 03/26/2023] Open
Abstract
Electroconvulsive therapy (ECT) is a safe and effective treatment modality for various psychiatric disorders. However, evidence suggests a putative role of ECT in treating movement disorders that are refractory to less invasive modalities. ECT is primarily used in treatment-resistant psychiatric disorders. However, growing evidence exists for its use in movement disorders with and without psychiatric comorbidity. The primary objective of this systematic review was to examine the efficacy of ECT as a primary treatment modality for movement disorders. Relevant, peer-reviewed publications were retrieved from PubMed, SCOPUS, CINAHL, and PsycINFO. Keywords related to ECT and movement disorders were used as search phrases to identify relevant articles. A total of 90 articles that met the inclusion criteria were included in this review. Core findings were subsequently appraised on the role of ECT in treating movement disorders. Inclusion and exclusion criteria were developed to guide the search and selection process. Sources that met the inclusion criteria were those published between 2001 and January 2023. Additionally, peer-reviewed journals published in the English language covering the role of ECT in movement disorders were deemed appropriate for inclusion. Sources published before 2001, written in a non-English language, and not from peer-reviewed journals were excluded from this systematic review. The exclusion criteria also entailed eliminating duplicates from the review list. Most reviewed sources revealed that ECT improved outcomes in symptoms associated with various movement symptoms. However, ECT does not have a long-lasting impact on neuroacanthocytosis symptoms. Additionally, ECT is negatively associated with aggression and agitation, two of the most critical movement symptoms of Alzheimer’s disease. Evidence affirms the efficacy of ECT in providing symptomatic relief for movement disorders aside from psychiatric comorbidities. This positive association highlights the need for randomized controlled studies to identify movement disorder sub-populations that may respond to ECT.
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Schoretsanitis G, Cicek M, Mathur N, Sanghani SN, Kane JM, Petrides G. Prolactin changes during electroconvulsive therapy: A systematic review and meta-analysis. J Psychiatr Res 2020; 128:25-32. [PMID: 32516627 DOI: 10.1016/j.jpsychires.2020.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/15/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Early studies reported a prolactin surge during electroconvulsive therapy (ECT). The aim of this study is to review and meta-analyze data on ECT-related prolactin changes. METHOD A systematic review and meta-analysis was conducted for trials investigating prolactin changes in ECT-treated patients using standard mean differences (SMD, 95% confidence intervals). Subgroup analyses included comparisons of ECT-related prolactin changes in women vs. men, patients receiving different anesthetics, bilateral vs. unilateral and high-vs. low-dose ECT. RESULTS In six trials including 109 ECT-treated patients and 74 controls, prolactin changes were larger in ECT-treated patients than in controls (SMD = 0.89, 95%CI = 0.55, 1.23, p < 0.001 and 1.03, 95%CI = 0.31, 1.75, p = 0.005 for the fixed and random-effect model respectively), despite heterogeneity in the samples (I2 = 72%, τ2 = 0.62). Effects were led by differences in patients premedicated with methohexital (SMD = 1.14, 95%CI = 0.7, 1.57, p < 0.001 for both fixed and random-effect model). A meta-regression reported significant age effects (coefficient estimate 2.32, 95%CI = -0.73, 3.91, p < 0.01). Additionally, prolactin changes were larger in ECT-treated women than men (SMD = 0.88, 95%CI = 0.58, 1.18, p < 0.001 and 0.99, 95%CI = 0.22, 1.75, p = 0.012 for the fixed and random effect model). Bilateral ECT-treated patients had larger increase than unilateral ECT-treated patients (SMD = -0.81, 95%CI = -1.35, -0.27, p = 0.003 and -0.86, 95%CI = -1.46, -0.25, p = 0.006 for the fixed and random-effect model). Comparisons between high- and low-dose ECT-treated patients could not be conducted. The quality of the studies was overall poor, with four exceptions. DISCUSSION Patients receiving ECT had larger prolactin increases than controls. Increases were larger in methohexital-premedicated patients, women vs. men and patients with bilateral vs. unilateral ECT.
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Affiliation(s)
| | - Mustafa Cicek
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Zurich, Switzerland
| | - Nandita Mathur
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA
| | - Sohag N Sanghani
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA
| | - John M Kane
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA; Hofstra Northwell School of Medicine, Hempstead, New York and the Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Georgios Petrides
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA; Hofstra Northwell School of Medicine, Hempstead, New York and the Feinstein Institute for Medical Research, Manhasset, NY, USA
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Gupta AK, Kumar GK, Rani K, Pokhriyal R, Khan MI, Kumar DR, Goyal V, Tripathi M, Gupta R, Chadda RK, Vanamail P, Mohanty AK, Hariprasad G. 2D-DIGE as a strategy to identify serum protein biomarkers to monitor pharmacological efficacy in dopamine-dictated states of Parkinson's disease and schizophrenia. Neuropsychiatr Dis Treat 2019; 15:1031-1044. [PMID: 31114209 PMCID: PMC6488160 DOI: 10.2147/ndt.s198559] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Parkinson's disease and schizophrenia are clinical scenarios that occur due to dopaminergic deficit and hyperactivity in the midbrain, respectively. Current pharmacological interventions for these two diseases therefore aim to restore normal dopamine levels in the midbrain. But during therapy, there is a overshooting of dopamine concentrations that result in hallucinations in Parkinson's disease patients and extra-pyramidal symptoms in schizophrenic patients. This causes a lot of inconvenience to the patents and the clinicians. There are no tests currently available to monitor drug efficacy in these two neuropsychiatric diseases. MATERIALS AND METHODS Parkinson's disease and schizophrenic naïve patients were recruited. Serum proteins isolated from these two clinical phenotypes were labeled with fluorescent cyanine dyes and analyzed by two-dimensional difference in gel electrophoresis proteomic experiment. Differentially expressed spots that had consistent expression pattern across five sets of biological replicate gels were trypsin digested and subjected to mass spectrometric analysis for protein identification. Validation experiments were done for the identified proteins using antibody-based assay on a patient cohort that included naïve, treated, and those who had side effects. RESULTS Serum α- and β-globin chains were identified as differentially expressed proteins having threefold higher expressions in Parkinson's patients as compared to schizophrenia. Interestingly, concentrations of these two proteins had an inverse correlation across clinical phenotypes in the dopaminergic spectrum. RBC contamination as a source for these proteins was ruled out. CONCLUSION There is a clear association of free serum globin with dopaminergic clinical states. This lays a platform for protein biomarker-based monitoring of pharmacological efficacy in Parkinson's disease and schizophrenia.
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Affiliation(s)
- Ashish Kumar Gupta
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India,
| | - Gaurav Khunger Kumar
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India,
| | - Komal Rani
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India,
| | - Ruchika Pokhriyal
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India,
| | - Mohd Imran Khan
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India,
| | - Domada Ratna Kumar
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India,
| | - Vinay Goyal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Rishab Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Rakesh Kumar Chadda
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Perumal Vanamail
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Ashok Kumar Mohanty
- Proteomics Facility, National Diary Research Institute, Karnal, Haryana 132001, India
| | - Gururao Hariprasad
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India,
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Gupta AK, Pokhriyal R, Khan MI, Kumar DR, Gupta R, Chadda RK, Ramachandran R, Goyal V, Tripathi M, Hariprasad G. Cerebrospinal Fluid Proteomics For Identification Of α2-Macroglobulin As A Potential Biomarker To Monitor Pharmacological Therapeutic Efficacy In Dopamine Dictated Disease States Of Parkinson's Disease And Schizophrenia. Neuropsychiatr Dis Treat 2019; 15:2853-2867. [PMID: 31632033 PMCID: PMC6781638 DOI: 10.2147/ndt.s214217] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 08/13/2019] [Indexed: 12/24/2022] Open
Abstract
AIM Parkinson's disease and schizophrenia are clinical end points of dopaminergic deficit and excess, respectively, in the mid-brain. In accordance, current pharmacological interventions aim to restore normal dopamine levels, the overshooting of which culminates in adverse effects which results in psychotic symptoms in Parkinson's disease and extra-pyramidal symptoms in schizophrenia. Currently, there are no laboratory assays to assist treatment decisions or help foresee these drug side-effect outcomes. Therefore, the aim was to discover a protein biomarker that had a varying linear expression across the clinical dopaminergic spectrum. MATERIALS AND METHODS iTRAQ-based proteomic experiments along with mass spectrometric analysis was used for comparative proteomics using cerebrospinal fluid (CSF). CSF fluid was collected from 36 patients with Parkinson's disease, 15 patients with urological diseases that served as neurological controls, and seven schizophrenic patients with hallucinations. Validation included ELISA and pathway analysis to highlight the varying expression and provide plausible molecular pathways for differentially expressed proteins in the three clinical phenotypes. RESULTS Protein profiles were delineated in CSF from Parkinson's disease patients, neurological control and schizophrenia, respectively. Ten of the proteins that were identified had a linear relationship across the dopaminergic spectrum. α-2-Macroglobulin showed to be having high statistical significance on inter-group comparison on validation studies using ELISA. CONCLUSIONS Non-gel-based proteomic experiments are an ideal platform to discover potential biomarkers that can be used to monitor pharmaco-therapeutic efficacy in dopamine-dictated clinical scenarios. α-2 Macroglobulin is a potential biomarker to monitor pharmacological therapy in Parkinson's disease and schizophrenia.
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Affiliation(s)
| | | | | | | | | | | | | | - Vinay Goyal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
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Gupta AK, Rani K, Swarnkar S, Kumar GK, Khan MI, Pokhriyal R, Kumar DR, Goyal V, Tripathi M, Gupta R, Chadda RK, Vanamail P, Hariprasad G. Evaluation of Serum Apolipoprotein E as a Potential Biomarker for Pharmacological Therapeutic Efficacy Monitoring in Dopamine Dictated Disease Spectrum of Schizophrenia and Parkinson's disease: A Preliminary Study. J Cent Nerv Syst Dis 2018; 10:1179573518803585. [PMID: 30327579 PMCID: PMC6178121 DOI: 10.1177/1179573518803585] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 09/02/2018] [Indexed: 11/15/2022] Open
Abstract
AIM OF THE STUDY Parkinson's disease and schizophrenia are disease end points of dopaminergic deficit and hyperactivity, respectively, in the mid brain. Accordingly, current medications aim to restore normal dopamine levels, overshooting of which results in adverse effects of psychosis and extra-pyramidal symptoms, respectively. There are currently no available laboratory tests to guide treatment decisions or help predict adverse side effects of the drugs. The aim was to therefore explore the possibility of using apolipoprotein E as a biomarker to monitor pharmacological intervention in dopamine dictated states of Parkinson's disease and schizophrenia for optimum therapy. METHODS Naïve and treated, Parkinson's disease and schizophrenic patients were recruited from neurology and psychiatry clinics. Serum of healthy volunteers was collected as controls. Serum concentrations of apolipoprotein E was estimated by enzyme-linked immunosorbent assay (ELISA). Pathway analysis was carried out to delineate the interactions of apolipoprotein E in Parkinson's disease and schizophrenia. RESULTS Apolipoprotein E levels are higher in Parkinson's disease patients as compared with schizophrenic samples (P < .05). Also, post-treatment apolipoprotein E levels in both disease states were at par with levels seen in healthy controls. The interactions of apolipoprotein E validate the results and place the differential expression of the protein in Parkinson's disease and schizophrenia in the right perspective. CONCLUSION Apolipoprotein E concentration across the dopaminergic spectrum suggests that it can be pursued not only as a potential biomarker in schizophrenia and Parkinson's disease, but can also be an effective tool for clinicians to determine efficacy of drug-based therapy.
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Affiliation(s)
- Ashish Kumar Gupta
- Department of Biophysics, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Komal Rani
- Department of Biophysics, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Surabhi Swarnkar
- Department of Biophysics, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Gaurav Khunger Kumar
- Department of Biophysics, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Mohd Imran Khan
- Department of Biophysics, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Ruchika Pokhriyal
- Department of Biophysics, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Domada Ratna Kumar
- Department of Biophysics, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Vinay Goyal
- Department of Neurology, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Rishab Gupta
- Department of Psychiatry, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Rakesh Kumar Chadda
- Department of Psychiatry, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Perumal Vanamail
- Department of Biostatistics, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Gururao Hariprasad
- Department of Biophysics, All India
Institute of Medical Sciences, New Delhi, New Delhi, India
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Landau AM, Alstrup AK, Audrain H, Jakobsen S, Simonsen M, Møller A, Videbech P, Wegener G, Gjedde A, Doudet DJ. Elevated dopamine D1 receptor availability in striatum of Göttingen minipigs after electroconvulsive therapy. J Cereb Blood Flow Metab 2018; 38:881-887. [PMID: 28509598 PMCID: PMC5987930 DOI: 10.1177/0271678x17705260] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Electroconvulsive therapy (ECT), a direct form of brain stimulation, is an effective antidepressant. We hypothesized that the beneficial effects of ECT are mediated by increased dopaminergic neurotransmission, in which the baseline activity of D1 receptors may predict the response to ECT. We established a novel model of brain stimulation in Göttingen minipigs based on the protocol of ECT applied in humans. With positron emission tomography (PET), we determined a measure of dopaminergic neurotransmission with the dopamine D1 receptor antagonist [11C]SCH23390. Seven minipigs were anesthetized and completed PET at baseline, prior to the onset of ECT treatment, and at 24-48 h and 8-10 days after the end of a clinical course of ECT, consisting of 10 ECT sessions over a 3.5-week period. In all pigs, the binding of [11C]SCH23390 to striatal D1 receptors had increased by 24-48 h after ECT, and in most, binding returned towards baseline at 8-10 days. Increased binding was observed in inverse proportion to baseline binding rates. Increased binding to dopamine D1 receptors suggests facilitation of dopaminergic neurotransmission, which may contribute to the therapeutic effects of ECT. Importantly, the baseline binding capacity of D1 receptors predicts the magnitude of increased binding, up to a maximum binding capacity.
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Affiliation(s)
- Anne M Landau
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark.,2 Translational Neuropsychiatry Unit, Aarhus University and Hospital, Aarhus C, Denmark.,3 Center of Functionally Integrative Neuroscience, Aarhus University and Hospital, Aarhus C, Denmark
| | - Aage Ko Alstrup
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark
| | - Helene Audrain
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark
| | - Steen Jakobsen
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark
| | - Mette Simonsen
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark
| | - Arne Møller
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark.,3 Center of Functionally Integrative Neuroscience, Aarhus University and Hospital, Aarhus C, Denmark
| | - Poul Videbech
- 4 Centre of Mental Health, Glostrup & University of Copenhagen, Denmark
| | - Gregers Wegener
- 2 Translational Neuropsychiatry Unit, Aarhus University and Hospital, Aarhus C, Denmark
| | - Albert Gjedde
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark.,5 Center for Neuroscience, University of Copenhagen, Copenhagen, Denmark.,6 Department of Nuclear Medicine, University of Southern Denmark & Odense University Hospital, Odense, Denmark
| | - Doris J Doudet
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark.,7 Department of Medicine/Neurology, University of British Columbia, Vancouver, BC, Canada
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Antidepressant treatment effects on dopamine transporter availability in patients with major depression: a prospective 123I-FP-CIT SPECT imaging genetic study. J Neural Transm (Vienna) 2018; 125:995-1005. [DOI: 10.1007/s00702-018-1863-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/15/2018] [Indexed: 10/18/2022]
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Landau AM, Clark C, Jivan S, Doudet DJ. Antiparkinsonian Mechanism of Electroconvulsive Therapy in MPTP-Lesioned Non-Human Primates. NEURODEGENER DIS 2012; 9:128-38. [DOI: 10.1159/000334497] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 10/18/2011] [Indexed: 11/19/2022] Open
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