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Elektroconvulsietherapie (ECT) als behandelmogelijkheid voor motorische symptomen van M. Parkinson

Published online by Cambridge University Press:  11 January 2019

A.F.G. Leentjens*
Affiliation:
Afdeling Psychiatrie, Academisch Ziekenhuis Maastricht
W.W. van den Broek
Affiliation:
Afdeling Psychiatrie, Academisch Ziekenhuis Rotterdam, Dijkzigt
F.W. Vreeling
Affiliation:
Afdeling Neurologie, Academisch Ziekenhuis Maastricht
A. Honig
Affiliation:
Afdeling Psychiatrie, Academisch Ziekenhuis Maastricht
*
psychiater, Afdeling Psychiatrie, Academisch Ziekenhuis Maastricht, Postbus 5800, 6202 AZ Maastricht

Samenvatting

Naast de gangbare indicaties voor ECT op het gebied van de affectieve stoornissen, zijn ook positieve effecten van deze behandeling beschreven bij enkele neurologische ziektebeelden. De auteurs geven een overzicht van gepubliceerde onderzoeksresultaten en ziektegeschiedenissen met betrekking tot de effectiviteit van ECT bij de behandeling van motorische symptomen van Parkinson-patiënten met of zonder coëxistente depressieve stoornis. Het enige prospectieve gecontroleerde onderzoek maakt melding van een positief resultaat op de motorische symptomen dat tot zes weken na behandeling aanhoudt. Dit komt overeen met de resultaten van vrijwel alle open onderzoeken en gepubliceerde casus, waarbij verbeteringen beschreven worden, variërend van enkele weken tot vier juar. Twee open onderzoeken (één retrospectief en één prospectief) vinden geen effect op de motoriek.

De aangehaalde literatuur rechtvaardigt volgens de auteurs het opzetten van groter prospectief onderzoek naar de waarde van deze behandeling voor Parkinson-patiënten, en wel met name bij die groep patiënten waarbij de medicamenteuze behandelmogelijkheden uitgeput zijn.

Summary

Summary

The efficacy of ECT as a treatment for severe affective disorders is well known. Less well known is the fact that positive effects of ECT have been described in some neurological disorders as well. The authors review published case-histories and study results regarding the effectiveness of ECT as a treatment for motor symptoms in patients with Parkinson's disease, with or without concurrent depression. The only controlled study that has been published describes an improvement of motor symptoms for up to six weeks after treatment. This is in line with a number of open studies and case-histories, that describe positive effects lasting from several weeks up to four years after discontinuation of ECT treatment. Two open studies (one retrospective and one prospective) report no improvement.

In the authors' opinion, the quoted literature justifies larger controlled studies into the efficacy of ECT as a treatment for motor symptoms in Parkinson's disease, especially in the group of patients for which pharmacological treatment options have been exhausted.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1998

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References

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