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CLINICAL AND PARACLINICAL CHANGES IN PARKINSON'S DISEASE PATIENTS WITH DEPRESSION TREATED WITH MODIFIED ELECTROCONVULSIVE THERAPY
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Abstract
Objective: To evaluate the clinical and biochemical changes in dopamine, serotonin, and their metabolites in serum and cerebrospinal fluid in Parkinson's disease patients with depression treated with modified electroconvulsive therapy. Subjects and methods: 30 patients with Parkinson's disease and comorbid depression, with an average age of 59.6±11.44 (10 males, 20 females) who were poorly responsive to internal medicine treatment, were included. These patients have been diagnosed with Parkinson's disease according to the UK Parkinson’s Disease Society Brain Bank Diagnostic Criteria. The diagnosis of depression was made according to the diagnostic criteria of ICD-10. The level of depression was determined according to the BECK Depression Inventory Scale. The electric shock machine is the Spectrum 5000q 12031 model manufactured in the United States. The anesthetic used is 1% Propofol with a concentration of 200mg/20ml. The study was conducted as a prospective observational trial, with pre- and post-electroconvulsive follow-up. The dopamine, serotonin 5-HIAA, and DOPAC levels were measured using high-performance liquid chromatography. The electroconvulsive therapy was performed according to the standard modified electroconvulsive procedure. Results: The degree of motor dysfunction, as assessed by the UPDRS scale, significantly improved after treatment. The rate of patients with remission of depression symptoms was 46.7%, mild depression was 46.7%, moderate depression was 6.6%, and there were no severe cases. The average Beck depression score after treatment was 14.6±3.8, compared to 24.2±6.3 before treatment (p<0.001). The levels of 5-HIAA, serotonin, dopamine, and DOPAC in serum and cerebrospinal fluid all increased significantly after treatment (p<0.001). There were no adverse events or complications during the electroshock therapy. Conclusion: Modified electroconvulsive therapy improves motor symptoms, depression, and the levels of dopamine, serotonin, and their metabolites in Parkinson's disease patients with comorbid depression, with no observed adverse effects.
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Keywords
Parkinson's disease, depression, electroconvulsive therapy.
References
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