Thread: post on ECT
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Old 08-06-2009, 08:06 PM
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My father had PD and had ECT several times over a short period. He did improve for a few weeks. Apparently some doctors give maintenance ECT:

Titre du document / Document title
Maintenance electroconvulsive therapy for Parkinson's disease
Auteur(s) / Author(s)
AARSLAND D. (1) ; LARSEN J. P. (2) ; WAAGE Ř. (1) ; LANGEVELD J. H. (1) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Section of Geriatric Psychiatry, Psychiatric Hospital of Rogaland, Stavanger, NORVEGE
(2) Department of Neurology, Central Hospital of Rogafand, Stavanger, NORVEGE
Résumé / Abstract

In two patients with severe Parkinson's disease (PD) whose response to levodopa had decreased the parkinsonian motor symptoms responded to acute and maintenance unilateral electroconvulsive therapy (ECT). Case 1 relapsed while taking antiparkinsonian medication 2 and 3 months after two brief courses of ECT. After another relapse, he received maintenance ECT and stayed well for 13 months.

Case 2 relapsed 4 months after a course of ECT. Acute and maintenance ECT induced improvement for 14 months. Further relapses were treated with brief courses of ECT followed by maintenance ECT. Three and 4 years after their first ECT, the parkinsonian motor symptoms in these two patients are still markedly improved.

Neuropsychological assessments did not suggest ECT-induced long-term cognitive impairment. We conclude that maintenance ECT should be considered in PD patients who relapse after having responded to an initial course of ECT. There is an urgent need for controlled studies.

http://cat.inist.fr/?aModele=afficheN&cpsidt=2107607

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I love how the following research included only one type of PD patient:

"Eighteen patients with the predominantly akinetic rigid form of idiopathic PD"

"To assess gait, the time to walk a 10-meter distance was recorded. The time to perform a complex hand and arm movement test was used to measure upper limb bradykinesia. For the walk test, patients were instructed to walk as quickly as they could. For the complex movement test, patients were instructed to perform 10 flexion-extension movements in the elbow joint while simultaneously squeezing a rubber bulb twice during each flexion-extension cycle. "


Research Article
Placebo-controlled study of rTMS for the treatment of Parkinson's disease:

http://www3.interscience.wiley.com/c...0637/HTMLSTART

"The objective of this study is to assess the safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) for gait and bradykinesia in patients with Parkinson's disease (PD). In a double-blind placebo-controlled study, we evaluated the effects of 25 Hz rTMS in 18 PD patients. Eight rTMS sessions were performed over a 4-week period. Four cortical targets (left and right motor and dorsolateral prefrontal cortex) were stimulated in each session, with 300 pulses each, 100% of motor threshold intensity. Left motor cortex (MC) excitability was assessed using motor evoked potentials (MEPs) from the abductor pollicis brevis.

During the 4 weeks, times for executing walking and complex hand movements tests gradually decreased. The therapeutic rTMS effect lasted for at least 1 month after treatment ended. Right-hand bradykinesia improvement correlated with increased MEP amplitude evoked by left MC rTMS after individual sessions, but improvement overall did not correlate with MC excitability. rTMS sessions appear to have a cumulative benefit for improving gait, as well as reducing upper limb bradykinesia in PD patients. Although short-term benefit may be due to MC excitability enhancement, the mechanism of cumulative benefit must have another explanation"
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