Receipt of Electroconvulsive Therapy and Subsequent Development of Amyotrophic Lateral Sclerosis: A Cohort Study

Bioelectromagnetics · 2022 · Mixed · Low evidence

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MixedLow evidencePaper 927

Study snapshot

PublicationBioelectromagnetics · 2022

Study typecohort

Reported directionMixed

Evidence ratingLow

Abstract

Receipt of Electroconvulsive Therapy and Subsequent Development of Amyotrophic Lateral Sclerosis: A Cohort Study Gabor Mezei, Edmund Lau, Nelson D Pace, Jamie Schenk, Leeka Kheifets. Receipt of Electroconvulsive Therapy and Subsequent Development of Amyotrophic Lateral Sclerosis: A Cohort Study. Bioelectromagnetics. 2022 Feb;43(2):81-89. doi: 10.1002/bem.22389. 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. pubmed.ncbi.nlm.nih.gov

Machine Enhanced Logic

AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typecohort

Effect directionmixed

PopulationU.S. Medicare beneficiaries (1997–2017) with psychiatric conditions

Sample sizeNot supplied

ExposureNot supplied

Evidence strengthLowConfidence: 78% · Peer reviewed: yes

Main findings

In a cohort of more than one million U.S. Medicare beneficiaries, ALS occurrence was compared between psychiatric patients who received ECT and those who did not. The hazard ratio for ALS following ECT was 1.39 (95% CI: 0.69–2.80); among those receiving >10 ECT treatments the HR was 2.24 (95% CI: 1.00–5.01), and among subjects older than 65 years the HR was 3.03 (95% CI: 1.13–8.10). No monotonic exposure-response relationship was detected in categorical analyses.

Outcomes measured

Amyotrophic lateral sclerosis (ALS) incidence/occurrence

Limitations

Hazard ratio estimates described as imprecise (wide confidence intervals).
No monotonic exposure-response relationship detected in categorical analyses.
Authors state results provide weak support and call for additional studies in larger populations or where ECT is more common.

View raw extracted JSON

{
  "study_type": "cohort",
  "exposure": {
    "band": null,
    "source": "electroconvulsive therapy (ECT)",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": "U.S. Medicare beneficiaries (1997–2017) with psychiatric conditions",
  "sample_size": null,
  "outcomes": [
    "Amyotrophic lateral sclerosis (ALS) incidence/occurrence"
  ],
  "main_findings": "In a cohort of more than one million U.S. Medicare beneficiaries, ALS occurrence was compared between psychiatric patients who received ECT and those who did not. The hazard ratio for ALS following ECT was 1.39 (95% CI: 0.69–2.80); among those receiving >10 ECT treatments the HR was 2.24 (95% CI: 1.00–5.01), and among subjects older than 65 years the HR was 3.03 (95% CI: 1.13–8.10). No monotonic exposure-response relationship was detected in categorical analyses.",
  "effect_direction": "mixed",
  "limitations": [
    "Hazard ratio estimates described as imprecise (wide confidence intervals).",
    "No monotonic exposure-response relationship detected in categorical analyses.",
    "Authors state results provide weak support and call for additional studies in larger populations or where ECT is more common."
  ],
  "evidence_strength": "low",
  "confidence": 0.78,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "electroconvulsive therapy",
    "ECT",
    "amyotrophic lateral sclerosis",
    "ALS",
    "cohort study",
    "Medicare",
    "psychiatric conditions",
    "time-varying proportional hazards",
    "dose/number of treatments"
  ],
  "suggested_hubs": [
    {
      "slug": "occupational-exposure",
      "weight": 0.1,
      "reason": "Study concerns a medical procedure exposure rather than occupational exposure; hub match is weak/uncertain."
    }
  ]
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1002/bem.22389
PubMed: 35066895

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