Magnetic Seizure Therapy Compared to Electroconvulsive Therapy for Schizophrenia: A Randomized Controlled Trial

Background: Magnetic seizure therapy (MST) is a potential alternative to electroconvulsive therapy (ECT). However, reports on the use of MST for patients with schizophrenia, particularly in developing countries, which is a main indication for ECT, are limited.Methods: From February 2017 to July 2018...

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Autores principales: Jiangling Jiang, Jin Li, Yuanhong Xu, Bin Zhang, Jianhua Sheng, Dengtang Liu, Wenzheng Wang, Fuzhong Yang, Xiaoyun Guo, Qingwei Li, Tianhong Zhang, Yingying Tang, Yuping Jia, Zafiris J. Daskalakis, Jijun Wang, Chunbo Li
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Publicado: Frontiers Media S.A. 2021
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spelling oai:doaj.org-article:dc2ed22504cf45d1b3412cd73f3e45702021-12-01T01:36:47ZMagnetic Seizure Therapy Compared to Electroconvulsive Therapy for Schizophrenia: A Randomized Controlled Trial1664-064010.3389/fpsyt.2021.770647https://doaj.org/article/dc2ed22504cf45d1b3412cd73f3e45702021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.770647/fullhttps://doaj.org/toc/1664-0640Background: Magnetic seizure therapy (MST) is a potential alternative to electroconvulsive therapy (ECT). However, reports on the use of MST for patients with schizophrenia, particularly in developing countries, which is a main indication for ECT, are limited.Methods: From February 2017 to July 2018, 79 inpatients who met the DSM-5 criteria for schizophrenia were randomized to receive 10 sessions of MST (43 inpatients) or ECT (36 inpatients) over the course of 4 weeks. At baseline and 4-week follow-up, the Positive and Negative Syndrome Scale (PANSS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to assess symptom severity and cognitive functions, respectively.Results: Seventy-one patients who completed at least half of the treatment protocol were included in the per-protocol analysis. MST generated a non-significant larger antipsychotic effect in terms of a reduction in PANSS total score [g = 0.17, 95% confidence interval (CI) = −0.30, 0.63] and response rate [relative risk (RR) = 1.41, 95% CI = 0.83–2.39]. Twenty-four participants failed to complete the cognitive assessment as a result of severe psychotic symptoms. MST showed significant less cognitive impairment over ECT in terms of immediate memory (g = 1.26, 95% CI = 0.63–1.89), language function (g =1.14, 95% CI = 0.52–1.76), delayed memory (g = 0.75, 95% CI = 0.16–1.35), and global cognitive function (g = 1.07, 95% CI = 0.45–1.68). The intention-to-treat analysis generated similar results except for the differences in delayed memory became statistically insignificant. Better baseline cognitive performance predicted MST and ECT response.Conclusions: Compared to bitemporal ECT with brief pulses and age-dose method, MST had similar antipsychotic efficacy with fewer cognitive impairments, indicating that MST is a promising alternative to ECT as an add-on treatment for schizophrenia.Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT02746965.Jiangling JiangJin LiYuanhong XuBin ZhangJianhua ShengDengtang LiuWenzheng WangFuzhong YangXiaoyun GuoQingwei LiTianhong ZhangYingying TangYuping JiaZafiris J. DaskalakisJijun WangJijun WangJijun WangJijun WangChunbo LiChunbo LiChunbo LiChunbo LiFrontiers Media S.A.articlemagnetic seizure therapyelectroconvulsive therapyschizophreniarandomized controlled trialcognitive functionsPsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution DOAJ
collection DOAJ
language EN
topic magnetic seizure therapy
electroconvulsive therapy
schizophrenia
randomized controlled trial
cognitive functions
Psychiatry
RC435-571
spellingShingle magnetic seizure therapy
electroconvulsive therapy
schizophrenia
randomized controlled trial
cognitive functions
Psychiatry
RC435-571
Jiangling Jiang
Jin Li
Yuanhong Xu
Bin Zhang
Jianhua Sheng
Dengtang Liu
Wenzheng Wang
Fuzhong Yang
Xiaoyun Guo
Qingwei Li
Tianhong Zhang
Yingying Tang
Yuping Jia
Zafiris J. Daskalakis
Jijun Wang
Jijun Wang
Jijun Wang
Jijun Wang
Chunbo Li
Chunbo Li
Chunbo Li
Chunbo Li
Magnetic Seizure Therapy Compared to Electroconvulsive Therapy for Schizophrenia: A Randomized Controlled Trial
description Background: Magnetic seizure therapy (MST) is a potential alternative to electroconvulsive therapy (ECT). However, reports on the use of MST for patients with schizophrenia, particularly in developing countries, which is a main indication for ECT, are limited.Methods: From February 2017 to July 2018, 79 inpatients who met the DSM-5 criteria for schizophrenia were randomized to receive 10 sessions of MST (43 inpatients) or ECT (36 inpatients) over the course of 4 weeks. At baseline and 4-week follow-up, the Positive and Negative Syndrome Scale (PANSS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to assess symptom severity and cognitive functions, respectively.Results: Seventy-one patients who completed at least half of the treatment protocol were included in the per-protocol analysis. MST generated a non-significant larger antipsychotic effect in terms of a reduction in PANSS total score [g = 0.17, 95% confidence interval (CI) = −0.30, 0.63] and response rate [relative risk (RR) = 1.41, 95% CI = 0.83–2.39]. Twenty-four participants failed to complete the cognitive assessment as a result of severe psychotic symptoms. MST showed significant less cognitive impairment over ECT in terms of immediate memory (g = 1.26, 95% CI = 0.63–1.89), language function (g =1.14, 95% CI = 0.52–1.76), delayed memory (g = 0.75, 95% CI = 0.16–1.35), and global cognitive function (g = 1.07, 95% CI = 0.45–1.68). The intention-to-treat analysis generated similar results except for the differences in delayed memory became statistically insignificant. Better baseline cognitive performance predicted MST and ECT response.Conclusions: Compared to bitemporal ECT with brief pulses and age-dose method, MST had similar antipsychotic efficacy with fewer cognitive impairments, indicating that MST is a promising alternative to ECT as an add-on treatment for schizophrenia.Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT02746965.
format article
author Jiangling Jiang
Jin Li
Yuanhong Xu
Bin Zhang
Jianhua Sheng
Dengtang Liu
Wenzheng Wang
Fuzhong Yang
Xiaoyun Guo
Qingwei Li
Tianhong Zhang
Yingying Tang
Yuping Jia
Zafiris J. Daskalakis
Jijun Wang
Jijun Wang
Jijun Wang
Jijun Wang
Chunbo Li
Chunbo Li
Chunbo Li
Chunbo Li
author_facet Jiangling Jiang
Jin Li
Yuanhong Xu
Bin Zhang
Jianhua Sheng
Dengtang Liu
Wenzheng Wang
Fuzhong Yang
Xiaoyun Guo
Qingwei Li
Tianhong Zhang
Yingying Tang
Yuping Jia
Zafiris J. Daskalakis
Jijun Wang
Jijun Wang
Jijun Wang
Jijun Wang
Chunbo Li
Chunbo Li
Chunbo Li
Chunbo Li
author_sort Jiangling Jiang
title Magnetic Seizure Therapy Compared to Electroconvulsive Therapy for Schizophrenia: A Randomized Controlled Trial
title_short Magnetic Seizure Therapy Compared to Electroconvulsive Therapy for Schizophrenia: A Randomized Controlled Trial
title_full Magnetic Seizure Therapy Compared to Electroconvulsive Therapy for Schizophrenia: A Randomized Controlled Trial
title_fullStr Magnetic Seizure Therapy Compared to Electroconvulsive Therapy for Schizophrenia: A Randomized Controlled Trial
title_full_unstemmed Magnetic Seizure Therapy Compared to Electroconvulsive Therapy for Schizophrenia: A Randomized Controlled Trial
title_sort magnetic seizure therapy compared to electroconvulsive therapy for schizophrenia: a randomized controlled trial
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/dc2ed22504cf45d1b3412cd73f3e4570
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