The PWECT015 study was designed to compare the application of 0.15ms and 0.30ms pulse width in electroconvulsive therapy (ECT). Subjects will be compared both within groups and in-group via psychometric scales.
This study is a controlled randomized clinical trial. Patients (projected n=40 are randomized into two groups - blue (20) and red (20). Randomization will be blocked (size sample 4) - 1 allocator. ECT practitioners are aware which patient belongs to which group but are blinded to block size. Testers are blinded to what group the patients belong to and what ECT parameters are used. Patients and attending psychiatrists are also blinded as to which group the patient belongs to. The MECTA SIGMA device will be used for ECT. Cross-over titration by stimulation will be used during the application of ECT to find the seizure threshold (ST) as follows: RED GROUP 1. Session - Titration with 0.15ms 2. Session - Titration with 0.3 ms 3. Session and further - continue with 0.3 ms pulse width and 6x ST found during the second session. BLUE GROUP 1. Session - Titration with 0.30ms 2. Session - Titration with 0.15ms 3. Session and further - continue with 0.15ms pulse width and 6x ST found during the second session. Delivered energy is measured in percentage (%) of the maximum charge (in millicoulombs, mC) that the European version of the MECTA SIGMA device is able to administer. Total amount of ECT applications is individual and based on the clinical state of the patient. ECT outcome will be predicted via seizure duration (SD). If the seizure duration is less than 15s, the ECT dosage will be increased during next session by 100%. Throughout the ECT course, patients will be closely monitored by the testers via psychometric scales. Primary outcome of the study is measured via Time To Recovery (TTR) - which is measured after each ECT application. TTR is the time (in minutes) after which the patient is fully vigilant and aware of his surroundings after an ECT procedure. TTR will be compared both in-group and between groups. Other psychometric measures are specified in the outcome measures section.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
40
Patients are treated with ECT.
Psychiatric Department, General University Hospital and 1st Faculty of Medicine, Prague
Prague, Czech Republic, Czechia
RECRUITINGTime to Recovery (TTR)
time to when the patient is fully vigilant and aware of his surroundings after an ECT procedure
Time frame: immediately after each ECT procedure, measured in minutes.
ECCA (Electroconvulsive cognitive assesment)
cognitive screening optimized for measuring cognitive functions in patients before, during and after the course of ECT.
Time frame: T1: baseline, 2 days before the commencement of an ECT course, T2: during the course of ECT, between second and third ECT application, T3: after the course of ECT, within 2 days
AMI (Autobiographical Memory Interview)
This interview is intended to quantify retrograde amnesia following electroconvulsive therapy (ECT).
Time frame: T1: baseline, 2 days before the commencement of an ECT course, T2: after the course of ECT, within 2 days , T3: 2 months after the ECT course , T4: 4 months after the ECT course, T5: 6 months after the ECT course
MoCA (Montreal Cognitive Assessment)
Screening of cognitive functions, results used as an inclusion criteria of the study and for the determination of the cognitive baseline.
Time frame: T1: baseline, 2 days before the commencement of an ECT course, T2: 2 months after the ECT course, T3: 4 months after the ECT course, T4: 6 months after the ECT course
QIDS (The Quick Inventory of Depressive Symptomatology)
Rates depression symptoms via self-assessment
Time frame: T1: baseline, 2 days before the commencement of an ECT course, T2: during the course of ECT, between second and third ECT application, T3: after the course of ECT, within 2 days, T4: 2 months after ECT , T5: 4 months after ECT, T6: 6 months after ECT
MADRS (Montgomery-Asberg Depression Rating Scale)
Assessment of depression severity, objective scale based on clinicians interview with a patient, results also used as an inclusion criteria of the study.
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Time frame: T1: baseline, 2 days before the commencement of an ECT course, T2: during the course of ECT, between second and third ECT application, T3: after the course of ECT, within 2 days, T4: 2 months after ECT , T5: 4 months after ECT, T6: 6 months after ECT
BVMT-R (Brief Visuospatial Memory Test-Revised)
Neuropsychological assessment designed to evaluate visuospatial memory in patients.
Time frame: 1: baseline, 2 days before the commencement of an ECT course, T2: after the course of ECT, within 2 days , T3: 2 months after the ECT course , T4: 4 months after the ECT course, T5: 6 months after the ECT course
RAVLT (The Rey Auditory Verbal Learning Test)
Neuropsychological assessment designed to evaluate verbal memory in patients.
Time frame: 1: baseline, 2 days before the commencement of an ECT course, T2: after the course of ECT, within 2 days , T3: 2 months after the ECT course , T4: 4 months after the ECT course, T5: 6 months after the ECT course