Proton magnetic resonance spectroscopic analysis of changes in brain metabolites following electroconvulsive therapy in patients with major depressive disorder.

Objectives: The aim of this study was to evaluate the metabolic changes in the anterior cingulate cortex (ACC) induced by electroconvulsive therapy (ECT) in patients with MDD via 1H-MRS.Methods: The study was conducted on 13 MDD patients receiving ECT treatment and 14 healthy controls matched in terms of age, gender and education. The patients underwent six sessions of ECT. 1H-MRS imaging and psychometric evaluations obtained before 1st and after the 6th sessions. The control group also went through the same procedures except for ECT. N-Acetyl aspartate (NAA), choline (Cho) and creatine (Cr) metabolite levels and the creatine to metabolite ratios were measured.Results: There was no significant difference in the ACC metabolite levels of the patients and those of the controls at the baseline. ECT associated with a statistically significant decrease in the NAA/Cr ratio in ACC. All of the patients had responded to ECT treatment as measured with the clinical scales.Conclusions: The results has suggested that indirect proof of an increase in energy metabolism without any evidence of impaired neuronal viability in the ACC induced by ECT. The relative increase in Cr levels following ECT in MDD seems to be associated with improvement in clinical severity.Key pointsECT is one the most effective method in the treatment of acute MDD.The mechanism of ECT's antidepressant activity remains unclear but it is thought to be related to the regulation of prefrontal cortical or cingulate areas.In this study the patients underwent six sessions of ECT and after 1H-MRS imaging.The study revealed that baseline levels of metabolites in patients with MDD were not significantly different than those of control group.

Factors associated with the pain catastrophizing scale and validation in a sample of the Turkish population.

AIM: The aim of this study was to validate the Pain Catastrophizing Scale (PCS) in the Turkish population and to investigate its correlation with the demographic and clinical characteristics of patients. MATERIALS AND METHODS: Volunteer patients, who were scheduled for elective surgery and who applied to the Outpatient Clinic of Anesthesiology for preoperative evaluation, were asked to complete a PCS form. The patient's age, sex, educational level, marital status, presence of chronic pain, and American Society of Anesthesiologists score were recorded, and PCS scores and demographic variables were compared statistically. RESULTS: Of the 257 patients enrolled in the study, 136 were male, 121 female, and the median age was 40. The 3 subscales in the Turkish version of the PCS consisted of rumination, magnification, and helplessness. Internal consistency of PCS was found to be congruent with Cronbach's alpha = 0.90. Significantly higher PCS scores were found in women with chronic pain. In addition, patients who graduated from primary school had statistically higher scores compared to those who graduated from high school. CONCLUSION: In accordance with the original scale, demographic specifications of the Turkish version of the PCS were found congruent. PCS scores in our population were found compatible with the literature review.