Affiliations: [a] Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| [b] Department of Psychiatry and Behavioral Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
Correspondence to: Danny Bega, MD, Northwestern University Feinberg School of Medicine, Department of Neurology, 710N Lake Shore Drive, Abbott Hall, #1124, Chicago, IL 60611, USA. Tel.: +1 312 503 5706; Fax: +1 312 908 5073; E-mail: [email protected].
Abstract: Background:Huntington’s disease (HD) is a progressive neurodegenerative disease characterized by involuntary movements and neuropsychiatric decline. With suicide rates five times higher in patients with HD compared to the general population, there is a need for further research into the management of affective symptoms in these patients. Electroconvulsive therapy (ECT) has been long used as a treatment for severe or medication-refractory mood disorders and catatonia. There are some case studies demonstrating ECT’s positive effect on depression and agitation in HD, but the data is limited. Objective:In this single site case series, we review ECT use for four HD patients with medication-refractory depression and/or psychosis to better assess the utility of ECT in this population. We also compile and review the existing literature on the topic. Methods:A single-center retrospective case series was conducted reviewing the indications, outcomes, and regimen of ECT treatments. Literature review was conducted via PubMed. Results:Four patients received ECT treatment during an inpatient hospitalization with three continuing maintenance therapy as an outpatient. All four had improvements in depression, agitation, and suicidal ideation leading to successful hospital discharge. One of the four patients also demonstrated subjective improvement in cognitive and motor symptoms after ECT initiation. Nineteen reported cases were identified through the literature review and are summarized. Conclusions:This case series adds to the existing literature demonstrating the successful use of ECT for psychiatric symptoms in HD. Larger scale studies are warranted to further investigate the specific role and protocol for the use of ECT in the management of refractory depression and psychosis in this population.