Summary
Electroconvulsive therapy (ECT) was given to 16 non-depressed, non-demented patients with advanced Parkinson's disease (PD). In all the patients an antiparkinsonian effect was seen, lasting for 18 months in one patient, 3–5 months in seven patients, and a few days to four weeks in eight patients. After ECT the levels of homovanillic acid and neuropeptide Y in cerebrospinal fluid (CSF) were significantly increased. The eight patients with long lasting motor improvement after ECT had significantly lower CSF-3-methoxy-4-hydroxyphenylglycol compared to the group with short lasting improvement.
Five patients developed transitory mental confusion after ECT. In these patients, and in no others, a high albumin-ratio was found already before ECT was given-an indication of blood CSF barrier damage.
Our results suggest that ECT is valuable in patients with drug refractory PD or PD with intolerance to antiparkinsonian drugs.
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References
Abrams R (1989) ECT for Parkinson's disease [editorial]. Am J Psychiatry 146(11): 1391–1393
Andersen K, Balldin J, Gottfries C, Granérus A-K, Modigh K, Svennerholm L, Wallin A (1987) A double-blind evaluation of electroconvulsive therapy in Parkinson's disease with “on off” phenomena. Acta Neurol Scand 76: 191–199
Bach FW, Ekman R, Jensen FM (1986) Beta-endorphin-immunoreactive components in human cerebrospinal fluid. Regul Pept 16: 189–198
Barbeau A (1980) Biochemical ageing in Parkinson's disease. In: Amaducci L (ed) Ageing of the brain and dementia. Raven Press, New York, pp 275–285
Cummings JL (1992) Depression and Parkinson's disease: a review. Am J Psychiatry 149(4): 443–454
Douyon R, Serby M, Klutchko B, Rotrosen J (1989) ECT and Parkinson's disease revisited: a “naturalistic” study. Am J Psychiatry 146(11): 1451–1455
Ekman R, Larsson I, Malmquist M, Thorell J (1983) Radioimmunoassay of delta sleepinducing peptide using an iodinated p-hydroxyphenylpropionic acid derivate as tracer. Regul Pept 6: 371–378
Ekman R, Seryenius B, Castro MG, Lowry PJ, Cederlund A-S, Bergman O, Sjögren HO (1993) Biosynthesis of corticotropin-releasing hormone in human T-lymphocytes. J Neuroimmunol 44: 7–14
Faber R, Trimble MR (1991) Electroconvulsive therapy in Parkinson's disease and other movement disorders. Mov Disord 6(4): 293–303
Gjerris A, Werdelin L, Gjerris F, Sorensen PS, Rafaelsen OJ, Alling C (1987) CSF-amine metabolites in depression, dementia and in controls. Acta Psychiatr Scand 75: 619–628
Gottfries C-G, Bråne G, Gullberg B, Steen G (1982) A new rating scale for dementia syndromes. Arch Gerontol Geriatr 1: 311–330
Hoehn M, Yahr M (1967) Parkinsonism: onset, progression and mortality. Neurology 17: 427–442
Jori A, Dolfini E (1975) Effect on ECT and imipramine treatment on the concentration of 5-hydroxyindoleacetic acid (5HIAA) and homovanilic acid (HVA) in the cerebrospinal fluid of depressed patients. Psychopharmacologia 44: 87–90
Kapur S, Mann J (1993) Antidepressant action and the neurobiologic effects of ECT: human studies. In: Coffey CE (ed) The clinical science of electroconvulsive therapy. American Psychiatric Press Inc, Washington, pp 235–250
Link H, Tibbling G (1977) Principles of albumin and IgG analyses in neurological disorders. II. Relations of the concentrations of the proteins in serum and cerebrospinal fluid. Scand J Clin Lab Invest 37: 391–397
Montgomery S, Åsberg M (1979) A new depression scale designed to be sensitive to change. Br J Psychiatry 134: 382–389
Öhman S (1994) Diagnostic methods for demonstration of intrathecal sythesis of immunoglobulins within the central nervous system. Thesis, Linköping
Rudorfer MV, Risby ED, Hsiao JK, Linnoila M, Potter WZ (1988) ECT alters human monoamines in a different manner from that of antidepressant drugs. Psychopharmacol Bull 24: 396–399
Tibbling G, Link H, Öhman S (1977) Principles of albumin and IgG analyses in neurological disorders. I. Establishment of reference values. Scand J Clin Lab Invest 37: 385–390
Wallengren J, Ekman R, Sundler F (1987a) Occurrence and distribution of neuropeptides in the human skin. An immunocytochemical study on normal skin and blister fluid from inflamed skin. Acta Derm Venerol 67: 185–192
Wallengren J, Möller H, Ekman R (1987b) Occurrence of substance P, vasoactive intestinal peptide and calcitonin gene-related peptide in factitious and cold urticaria. Acta Dermatol Res 279: 512–515
Ward C, Stern G, Pratt R, McKenna P (1980) Electroconvulsive therapy in parkinsonian patients with the “on-off” syndrome. J Neural Transm 49: 133–135
Webster D (1968) Clinical analysis of the disability in Parkinson's disease. Mod Treatm 5: 257–282
Widerlöv E, Lindström LH, Wahlstedt C, Walleus H, Ekman R (1988) Neuropeptide Y (NPY) and peptide Y (PYY) as possible cerebrospinal fluid markers for major depression and schizophrenia, respectively. J Psychiatr Res 22: 69–79
Widerlöv E, Ekman R, Jensen L, Borglund L, Nyman K (1989) Arginine vasopressin, but not corticotropin releasing factor, is a potent stimulator of adrenocorticotropic hormone in electroconvulsive treatment. J Neural Transm 75: 101–109
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Fall, P.A., Ekman, R., Granérus, A.K. et al. ECT in Parkinson's disease. Changes in motor symptoms, monoamine metabolites and neuropeptides. J Neural Transm Gen Sect 10, 129–140 (1995). https://doi.org/10.1007/BF02251228
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DOI: https://doi.org/10.1007/BF02251228