Özden KAMIŞLI, Yüksel KAPLAN, Cemal ÖZCAN, M. Emin TAGLUK, Ertugrul DAL, Şükrü KARTALCI

Major Depresyon ve Psikotik Bozuklukta Elektrokonvülzif Tedavi Öncesi Çekilen EEG'nin Kantitatif İncelenmesinin Prognozdaki Rolü

Amaç: Bu çalışmada amacımız elektrokonvülzif tedaviden fayda görecek veya görmeyecek hastaları, elektrokonvülzif tedavi işlemi öncesi çekilecek elektroensefalografilerini inceleyerek önceden tahmin edebilmektir. Gereç ve Yöntemler: Bu çalışmaya psikotik bozukluk ve majör depresyon tanılı toplam 40 hasta alındı. Hastaların elektroensefalografileri elektrokonvülzif tedavi öncesi çekildi. Hastaların elektrokonvülzif tedaviden fayda görüp görmediği majör depresyonlu hastalarda tedavi öncesi ve 6-12 seanslık tedavi sonrası Hamilton depresyon ölçeği puanları ile psikotik hastalarda yine tedavi öncesi ve 6-12 seanslık tedavi sonrası pozitif ve negatif semptomları derecelendirme ölçekleri puanları ile değerlendirildi. Bulgular: Her elektrot işareti zaman ekseninde kayan genliği 1 ve T=500 örnek uzunluğunda bir pencere ile üst üste gelmeyecek şekilde pencerelenerek, her iki çift pencere arasındaki ilinti değerlendirildi. Global ve elektrot bazında oluşturulan bu endeks sonuçlarının iki grup arasında anlamlı bir fark oluşturmadığı görüldü. Her bir elektrot elektroensefalografi işaretlerinin alt bandı diğer elektrotlara ait aynı alt bant ilintisini alıp ve toplam ortalama ilinti gücünü temsil eden global bir endeks oluşturuldu ve değerlendirildi. Ayrıca sağ ve sol hemisferler arasındaki simetri indeksi değerlendirildi ancak anlamlı bir fark bulunamadı. Sonuç: Sonuç olarak elektrokonvülzif tedavi öncesi hastalardan çekilen elektroensefalografi analizinden hastanın elektrokonvülzif tedaviden fayda görüp görmeyeceği yapılan bu çalışma ile anlaşılamadı. Ancak bu olumsuz bulguyu standardize etmek için literatürde var olan tüm metotların denenmesi, belki de yeni metotlar geliştirip uygulamak faydalı olabilir.

Prognostic Value of Quantative EEG Prior to Electroconvulsive Therapy in Psychotic Disorders and Major Depression

Aim: Our aim is to predict the patients who may benefit from electroconvulsive therapy by examining quantative electroencephalographies' captured before the electroconvulsive therapy procedure. Meterial and Methods: A total of 40 patients with psychotic disorder or major depression were included in this study. Electroencephalographies were obtained before electroconvulsive therapy. The Hamilton depression scale scores of the patients with major depression and the positive and negative symptom rating scale scores of psychotic patients before and after 6-12 sessions of electroconvulsive therapy was used to determine whether electroconvulsive therapy was beneficial. Electroencephalography data were analyzed with the Fourier analysis method. Results: Every electrode signal recorded from the patient electroencephalography in Matlab environment was windowed with a window of sliding amplitude in time axis 1 and length of T=500. The correlation between two windows was quantified. Results generated on a global and electrode basis were observed to not show a significant difference between the two groups .The sub-band for the electroencephalography signals of each electrode and the correlation of the same sub-band belonging to other electrodes were acquired and a global index representing the total mean correlation power was calculated. The symmetry index between the right and left hemisphere in electroencephalographies was also not significant. Conclusion: In this study we were unable to determine whether a patient would benefit from electroconvulsive therapy using the Electroencephalography signals obtained prior to the treatment. The determination of whether such predictive parameters are of clinical utility for the prediction of outcome awaits further studies.

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