Association of treatment facets, severity of manic symptoms, psychomotor disturbances and psychotic features with response to electroconvulsive therapy in bipolar depression

Brancati, Giulio Emilio; Tripodi, Beniamino; Novi, Martina; Barbuti, Margherita; Medda, Pierpaolo; Perugi, Giulio

doi:10.1080/15622975.2020.1770860

Cited by 8 publications

(9 citation statements)

References 36 publications

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“…For example, actigraphy may help to objectively identify and quantify psychomotor retardation in depression that is associated with more severe depression syndromes (Parker, 2000; Ulbricht et al, 2018). As psychomotor disturbance predicts better outcome of electroconvulsive therapy and might predict response to different classes of antidepressants, objective assessment of retardation may also inform therapy planning (Brancati et al, 2021; Buyukdura et al, 2011; Heijnen et al, 2019; Hickie, Mason, Parker, & Brodaty, 1996; Schrijvers et al, 2008; Valerio, Szmulewicz, & Martino, 2018; van Diermen et al, 2019). Moreover, actigraphy can enhance detection of depression in primary care settings with limited resources (Minaeva et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Actigraphically measured psychomotor slowing in depression: systematic review and meta-analysis

et al. 2022

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Psychomotor slowing is a key feature of depressive disorders. Despite its great clinical importance, the pathophysiology and prevalence across different diagnoses and mood states are still poorly understood. Actigraphy allows unbiased, objective, and naturalistic assessment of physical activity as a marker of psychomotor slowing. Yet, the true effect-sizes remain unclear as recent, large systematic reviews are missing. We conducted a novel meta-analysis on actigraphically measured slowing in depression with strict inclusion and exclusion criteria for diagnosis ascertainment and sample duplications. Medline/PubMed and Web-of-Science were searched with terms combining mood-keywords and actigraphy-keywords until September 2021. Original research measuring actigraphy for ⩾24 h in at least two groups of depressed, remitted, or healthy participants and applying operationalized diagnosis was included. Studies in somatically ill patients, N < 10 participants/group, and studies using consumer-devices were excluded. Activity-levels between groups were compared using random-effects models with standardized-mean-differences and several moderators were examined. In total, 34 studies (n = 1804 patients) were included. Patients had lower activity than controls [standardized mean difference (s.m.d.) = −0.78, 95% confidence interval (CI) −0.99 to −0.57]. Compared to controls, patients with unipolar and bipolar disorder had lower activity than controls whether in depressed (unipolar: s.m.d. = −0.82, 95% CI −1.07 to −0.56; bipolar: s.m.d. = −0.94, 95% CI −1.41 to −0.46), or remitted/euthymic mood (unipolar: s.m.d. = −0.28, 95% CI −0.56 to 0.0; bipolar: s.m.d. = −0.92, 95% CI −1.36 to −0.47). None of the examined moderators had any significant effect. To date, this is the largest meta-analysis on actigraphically measured slowing in mood disorders. They are associated with lower activity, even in the remitted/euthymic mood-state. Studying objective motor behavior via actigraphy holds promise for informing screening and staging of affective disorders.

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Section: Discussionmentioning

confidence: 99%

Actigraphically measured psychomotor slowing in depression: systematic review and meta-analysis

et al. 2022

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“…On the other hand, in many regions, the greater changes after 6 months were observed in patients with greater changes at the end of the ECT series, suggesting the possibility of durable influences on brain structure. In animal models, newborn cells after a single ECS were found to differentiate and survive for at least 3 months and the number of neurons formed was positively correlated with the number of ECS trials administered [13], resembling the relationship observed between response probability and number of treatments in humans [50]. Increased gray matter volumes in the long-term could thus be explained by the neurotrophic effects which would underlie volume increases at the end of the treatment course.…”

Section: Discussionmentioning

confidence: 61%

Short and long-term effects of single and multiple sessions of electroconvulsive therapy on brain gray matter volumes

et al. 2021

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Section: Discussionmentioning

confidence: 99%

“…Notably, ECT has been found highly effective in patients with bipolar depression and mixed syndromes [32,33]. Importantly, the severity of psychomotor disturbances, including both motor retardation and agitation, has been positively associated with higher response rates in patients with bipolar disorder or major depression [32,34]. Despite some authors suggesting the use of unilateral ECT in PD patients in order to reduce cognitive side effects [35,36], bilateral ECT was adopted in our patients in accordance with most reports of ECT in catatonic patients [37].…”

Section: Discussionmentioning

confidence: 99%

Catatonia in two women with Parkinson’s disease treated with electroconvulsive therapy

Elefante

Brancati

Tripodi³

et al. 2022

Explor Neuroprot Ther

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Catatonia is a neuropsychiatric syndrome characterized by a broad range of motor, behavioral and cognitive abnormalities. Catatonia and Parkinson’s disease (PD) may show partially overlapping symptomatology. For this reason, catatonia could be misdiagnosed and overlooked in patients with severe PD, leading to a delay in proper treatment with benzodiazepines or electroconvulsive therapy (ECT). Two cases of women with PD and catatonia who have been admitted and treated with ECT at the University Hospital of Pisa are described here. Both had a history of bipolar disorder and developed withdrawn catatonia, in the context of affective episodes, approximately one year after the diagnosis of PD. In both cases, ECT was needed and successfully led to the remission of catatonic symptoms, without cognitive worsening. Since ECT appears to effectively treat catatonia in patients with PD, clinicians should consider it as a therapeutic option.

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Association of treatment facets, severity of manic symptoms, psychomotor disturbances and psychotic features with response to electroconvulsive therapy in bipolar depression

Cited by 8 publications

References 36 publications

Actigraphically measured psychomotor slowing in depression: systematic review and meta-analysis

Actigraphically measured psychomotor slowing in depression: systematic review and meta-analysis

Short and long-term effects of single and multiple sessions of electroconvulsive therapy on brain gray matter volumes

Catatonia in two women with Parkinson’s disease treated with electroconvulsive therapy

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