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극단파 우측 단측성 전기경련치료의 초기 경련 역치

Initial Seizure Threshold in Ultra-Brief Pulse Width Right Unilateral Electroconvulsive Therapy

신경정신의학 2020년 59권 4호 p.311 ~ 318
김효섭, 신샘이, 정성훈, 김예니, 윤탁, 정지훈, 김용식, 정인원,
소속 상세정보
김효섭 ( Kim Hyo-Seob ) - Dongguk University International Hospital Department of Psychiatry
신샘이 ( Shin Sam-Yi ) - Dongguk University Graduate School Department of Psychiatry
정성훈 ( Jeong Seong-Hoon ) - Eulji University Daejeon Eulji Medical Center Department of Psychiatry
김예니 ( Kim Ye-Ni ) - Dongguk University International Hospital Department of Psychiatry
윤탁 ( Youn Tak ) - Dongguk University International Hospital Department of Psychiatry
정지훈 ( Chung Chi-Hoon ) - Dongguk University International Hospital Department of Psychiatry
김용식 ( Kim Yong-Sik ) - Eulji University Nowon Eulji Medical Center Department of Psychiatry
정인원 ( Chung In-Won ) - Dongguk University International Hospital Department of Psychiatry

Abstract


Objectives: The present study investigates the initial seizure threshold (IST) of an ultra-brief pulse width right unilateral electroconvulsive therapy (UBP-RUL ECT) in Korean patients with mental disorders to identify its predictive factors for clinical improvement.

Methods: This study includes thirty patients who received 0.3-ms UBP-RUL ECT using upward titration to measure IST after the use of general anesthesia and muscle relaxation between December 2015 and June 2020. During the second session, the amount of charge that ranged between 500% to 600% of IST was applied as the stimulus intensity (SI). Demographic and clinical information was gathered from electronic medical records, and a stepwise variable selection was conducted to identify the relevant predictors of IST.

Results: The mean age of study subjects was 49.7±18.3 years, and 12 (40.0%) patients were male. The mean IST and SI were 31.6±17.2 mC and 176.0±98.5 mC, respectively, which did not differ between males and females. The mean scores of the Clinical Global Impression-severity and the Clinical Global Impression-improvement before and after acute ECT were 5.8±0.8 and 2.1±0.7, respectively. The age and anesthetic dose per body weight were significant predictors of IST. However, the IST and SI were not associated with clinical improvement.

Conclusion: The present study demonstrated that the IST distribution for UBP-RUL ECT in Korean patients with mental disorders was comparable to those reported in previous literature. The IST was associated with age and anesthetic dose.

키워드

정신장애; 전기경련치료; 초기경련역치; 극단파폭; 우측 단측성 전극 위치
Mental disorder; Electroconvulsive therapy; Initial seizure threshold; Ultra-brief pulse width; Right unilateral electrode placement

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