Electroconvulsive therapy in children and adolescents in Europe-a systematic review of the literature complemented by expert information and guideline recommendations

Licht, Christiane; Weirich, Steffen; Reis, Olaf; Kölch, Michael; Grözinger, Michael

doi:10.1007/s00787-023-02248-y

Cited by 4 publications

(2 citation statements)

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“…TMS and tES are the most used noninvasive brain stimulation techniques in children and adolescents, and this review is focused on the safety aspects of these techniques in children and adolescents. There are, however, other noninvasive brain stimulation techniques, including electroconvulsive therapy (ECT) [5], transcutaneous vagus nerve stimulation (tVNS) [6], and trigeminal nerve stimulation (TNS) [7] that are less commonly used in children so far.…”

Section: What Is Noninvasive Brain Stimulation?mentioning

confidence: 99%

Safety of noninvasive brain stimulation in children

Salehinejad,

Siniatchkin

2024

Current Opinion in Psychiatry

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Purpose of review Noninvasive brain stimulation (NIBS) is a promising method for altering cortical excitability with clinical implications. It has been increasingly used in children, especially in neurodevelopmental disorders. Yet, its safety and applications in the developing brain require further investigation. This review aims to provide an overview of the safety of commonly used NIBS techniques in children, including transcranial electrical stimulation (tES) and transcranial magnetic stimulation (TMS). Safety data for other NIBS methods is not reported in this review. Recent findings In line with studies from the last decade, findings in the last 2 years (2022–2023) support the safety of NIBS in children and adolescents within the currently applied protocols. Both tES and TMS are well tolerated, if safety rules, including exclusion criteria, are applied. Summary We briefly discussed developmental aspects of stimulation parameters that need to be considered in the developing brain and provided an up-to-date overview of tES/TMS applications in children and adolescents. Overall, the safety profile of tES/TMS in children is good. For both the tES and TMS applications, epilepsy and active seizure disorder should be exclusion criteria to prevent potential seizures. Using child-sized earplugs is required for TMS applications. We lack large randomized double-blind trials and longitudinal studies to establish the safety of NIBS in children. Video abstract http://links.lww.com/YCO/A78.

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Section: What Is Noninvasive Brain Stimulation?mentioning

confidence: 99%

Safety of noninvasive brain stimulation in children

Salehinejad,

Siniatchkin

2024

Current Opinion in Psychiatry

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“…However, its use for adolescent depression, whose rates are rising over these past years (reviewed by Keyes and Platt, 2023 ), is almost inexistent, even though prior reports suggested that it is safe and efficacious for this age group (e.g., Castaneda-Ramirez et al, 2023 ). Consequently, the generation of new high-quality data, improved experience and additional knowledge for child and adolescent psychiatrists would be key to increase the clinical use of ECT for adolescents ( Licht et al, 2023 ). Moreover, besides age, biological sex should be considered when defining the specific parameters that will be needed to induce efficacy ( Sackeim et al, 1987 ; Rasimas et al, 2007 ; Peterchev et al, 2010 ; Lemasson et al, 2018 ; Güney et al, 2020 ; Blanken et al, 2023 ), since prior reports described that women required a lower charge to induce an optimal seizure than men at the same age, and for both sexes the charge needed increased with age ( Salvador Sánchez et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Electroconvulsive seizures regulate various stages of hippocampal cell genesis and mBDNF at different times after treatment in adolescent and adult rats of both sexes

Ledesma-Corvi,

García-Fuster

2023

Front. Mol. Neurosci.

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Electroconvulsive therapy, a fast-acting option for treatment-resistant depression, is modeled at the preclinical level through the induction of electroconvulsive seizures (ECS) in rodents. Recent studies from our group proved sex- and age-differences in the antidepressant-like response elicited by ECS in rats; while an antidepressant-like response was observed in male adolescent and adult rats (although with greater efficacy in adulthood), the same parameters rendered inefficacious in females of any age. To better understand the potential sex differences taking place at the molecular level that might be mediating these behavioral disparities, we evaluated the impact of a repeated treatment with ECS (95 mA for 0.6 s, 100 Hz, 0.6 ms) in adolescent and adult rats of both sexes. Several hippocampal markers of neuroplasticity, commonly regulated by most antidepressants, such as those of neurogenesis (cell proliferation, neurogenic differentiation, long-term cell survival) or mBDNF and associated signaling (e.g., mTOR and ERK1/2) were evaluated at different time-points after treatment (1-, 8-, 15- and up to 30-days post-treatment). The main results demonstrated that ECS improved the survival rate of new cells born in the dentate gryus before treatment. Moreover, ECS increased cell proliferation and neurogenic differentiation at different times post-treatment, paired with persistent increases in mBDNF, observed long after treatment. In general, effects were different for each sex and varied with the age of the animal (adolescent vs. adulthood). The present study is the first-one to demonstrate that such persistent molecular changes induced by ECS in hippocampus, some of them observed up to 30-days post-treatment, also occurred in female rats and adolescence. Although these molecular changes could not justify the lack of ECS efficacy described by these same parameters of ECS in female rats (vs. male rats), they proposed certain beneficial effects common to both sexes, and age periods studied, opening the avenue for further studies. Based on these neurochemical effects, ECS should have displayed similar efficacies for both biological sexes. Therefore, the reason behind these disparities should be further explored to better translate efficacious treatments specific and/or personalized for each sex to the clinic.

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