Receipt of Electroconvulsive Therapy and Subsequent Development of Amyotrophic Lateral Sclerosis: A Cohort Study
We investigated the potential relationship between receipt of electroconvulsive therapy (ECT) and development of amyotrophic lateral sclerosis (ALS). We conducted a cohort study using a sample of more than one million beneficiaries enrolled in the U.S. Medicare health insurance program from 1997 to...
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Published in | Bioelectromagnetics Vol. 43; no. 2; pp. 81 - 89 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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01.02.2022
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Abstract | We investigated the potential relationship between receipt of electroconvulsive therapy (ECT) and development of amyotrophic lateral sclerosis (ALS). We conducted a cohort study using a sample of more than one million beneficiaries enrolled in the U.S. Medicare health insurance program from 1997 to 2017. Using time‐varying proportional hazard modeling, we compared ALS occurrence among patients diagnosed with psychiatric conditions who received ECT to ALS occurrence among patients diagnosed with psychiatric conditions but who did not receive ECT. We observed moderately increased, but imprecise, hazard ratios (HR) for ALS following ECT (HR = 1.39, 95% confidence interval [CI]: 0.69–2.80). A statistically significant increase in the HR of ALS was observed among those who received more than 10 ECT treatments (>10 treatments, HR = 2.24, 95% CI: 1.00–5.01), compared to those receiving no ECT, with an even stronger association observed among subjects older than 65 years (HR = 3.03, 95% CI: 1.13–8.10). No monotonic exposure‐response relationship was detected in categorical analyses. Our results provide weak support for the hypothesis that receipt of ECT increases the risk of developing ALS. Additional studies in larger populations, or in populations where ECT is more common, will be needed to refute or confirm an association between receipt of ECT and subsequent development of ALS. Bioelectromagnetics. 43:81–89, 2022. © 2021 Bioelectromagnetics Society. |
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AbstractList | We investigated the potential relationship between receipt of electroconvulsive therapy (ECT) and development of amyotrophic lateral sclerosis (ALS). We conducted a cohort study using a sample of more than one million beneficiaries enrolled in the U.S. Medicare health insurance program from 1997 to 2017. Using time‐varying proportional hazard modeling, we compared ALS occurrence among patients diagnosed with psychiatric conditions who received ECT to ALS occurrence among patients diagnosed with psychiatric conditions but who did not receive ECT. We observed moderately increased, but imprecise, hazard ratios (HR) for ALS following ECT (HR = 1.39, 95% confidence interval [CI]: 0.69–2.80). A statistically significant increase in the HR of ALS was observed among those who received more than 10 ECT treatments (>10 treatments, HR = 2.24, 95% CI: 1.00–5.01), compared to those receiving no ECT, with an even stronger association observed among subjects older than 65 years (HR = 3.03, 95% CI: 1.13–8.10). No monotonic exposure‐response relationship was detected in categorical analyses. Our results provide weak support for the hypothesis that receipt of ECT increases the risk of developing ALS. Additional studies in larger populations, or in populations where ECT is more common, will be needed to refute or confirm an association between receipt of ECT and subsequent development of ALS. Bioelectromagnetics. 43:81–89, 2022. © 2021 Bioelectromagnetics Society. |
Author | Pace, Nelson D. Kheifets, Leeka Lau, Edmund Mezei, Gabor Schenk, Jamie |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35066895$$D View this record in MEDLINE/PubMed |
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Notes | Conflicts of interest: GM has provided scientific consulting services for electric power companies. LK has received funding from the Electric Power Research Institute for other studies. EL, NDP, and JS have no conflicts of interest to declare. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
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SubjectTerms | Aged Amyotrophic lateral sclerosis Amyotrophic Lateral Sclerosis - epidemiology Amyotrophic Lateral Sclerosis - therapy Cohort analysis Cohort Studies Confidence intervals electric and magnetic fields electric current Electroconvulsive Therapy epidemiology Government programs Humans Medicare motor neuron disease Motor neurone disease Population studies Populations Statistical analysis United States |
Title | Receipt of Electroconvulsive Therapy and Subsequent Development of Amyotrophic Lateral Sclerosis: A Cohort Study |
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