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A few days ago, there were some questions regarding the use of electroshock treatments in the treatment of Parkinson's disease. I posted a brief message urging caution with using a procedure which has been shown to cause brain dysfunction. Janet followed by a list of references, and Dr. Charlie also spoke favorably of ECT in Parkinson's. I did a PubMed challenge this morning and came up with the following (I reviewed the abstracts of Janet's citations as part of this): 1. Dopamine uptake studies (Linkoping University, Sweden, 2000) showed that there was no difference in uptake of a radiotracer before or after ECT. The conclusion of the study said that patients with less- severe forms of PD did better with ECT. The total number of patients in the study was 6! 2. Beth Israel Hospital, New York, 2000. Elderly patients with "multiple system atrophy" (not PD) (this is "Parkinsonian", not PD). "All patients improved neurologically, but none regained independent ambulation". Total number of patients in the study: 3! 3. USC Medical School, December, 1999. Journal of ECT. 56 patients over 4 1/2 years. Mixed diagnoses. Only a few with PD (most with psychiatric diagnoses). No results for PD directly quoted. I have asked my medical librarian to get the entire article 4. Erszebet Korhaz Hospital, Sopron, Hungary, September, 1999. Shock treatment by "magnetic stimulation". Twice a day therapy. Claims some improvement for about 3 months after "repetitive" magnetic stimulation over weeks (twice a day). I am not aware of the value of "magnetic stimulation" for *any* illness. 5. University of Nebraska Medical Center, Summer 1998. Study of patients with "intractable Parkinson's disease". Total number of patients in series: 4! Two patients got worse (congnitive deterioration and development of delusions); two patients had "reductions in 'off times' for short periods". The shock treatments were used for periods between four weeks and twelve months! 6. Department of Geriatric Medicine, Linkoping, Sweden, 1995. Sixteen patients given ECT for PD. All were non-depressed and non- demented. 5 patients were mentally confused after treatment. 1 patient had improvement of PD symptoms for 18 months. 7 patients had some improvement for up to 3-5 months. 8 patients were improved for "a few days". 7. Mayo Clinic, Spring 1998. Series of 25 patients given ECT for "psychiatric complications of Parkinson's disease" (NOTE: Not given for tremor, rigidity, etc.). 14 (out of 25) "were noted to have at least transient improvement in motor function at discharge" (they don't say how much or how long). The conclusion of the article is "ECT is an effective treatment for patients with parkinsonism and psychiatric comorbidity". (I am not sure how they arrived at this conclusion). So, folks, here is the "evidence" (for ECT being of value in PD). My skepticism (and cautions) are as strong as before! Best, Bob ********************************************** Robert A. Fink, M. D., F.A.C.S., P. C. 2500 Milvia Street Suite 222 Berkeley, California 94704-2636 Telephone: 510-849-2555 FAX: 510-849-2557 WWW: http://www.rafink.com/ mailto:[log in to unmask] "Ex Tristitia Virtus" *********************************************