Effect of esketamine and etomidate anesthesia on neuroplasticity in electroconvulsive therapy for treatment-resistant depression

Table 1 Comparison of general data between two groups of patients, n (%)

Group	n	Age (years)	BMI (kg/m2)	Gender		Smoke	Alcohol	Course of disease (months)	Years of education (years)	Pretherapy HAMD-24
				Male	Female
Combined group	56	33.8 ± 8.1	24.10 ± 2.14	38 (67.86)	18 (32.14)	31 (55.36)	35 (62.50)	15.81 ± 8.80	11.7 ± 3.0	41.8 ± 4.3
Control group	54	34.5 ± 8.9	23.76 ± 2.34	34 (62.96)	20 (37.04)	28 (51.85)	31 (57.41)	16.32 ± 8.73	12.4 ± 3.4	40.5 ± 4.1
t/χ2		-1.043	0.792	0.291		0.136	0.297	-1.449	-1.140	1.615
P value		0.299	0.430	0.589		0.712	0.586	0.150	0.257	0.109

BMI: Body mass index; HAMD-24: Hamilton Depression Scale-24.

Table 2 Comparison of electroconvulsive therapy monitoring indicators between combination group and control group

	n	Initial threshold charge (mc)	Final threshold charge (mc)	Total treatment electricity (mc)	Mean seizure duration (mc)
Combined group	56	116.02 ± 13.76	144.01 ± 13.73	1266.07 ± 212.01	50.06 ± 8.08
Control group	54	114.18 ± 14.56	170.23 ± 24.76	1866.02 ± 260.82	48.77 ± 8.82
t value		2.007	-52.149	-99.285	2.016
P value		0.475	0.000	0.000	0.478

Table 3 Comparison of Wisconsin Card Sorting Test scores between the combined group and the control group before and after treatment

	n	Total number of answers	Accuracy	Percentage of conceptualization level	Continuous response	Non persistent error	Number of categories completed
Combined group	56
Before treatment		129.73 ± 14.97	0.58 ± 0.15	0.45 ± 0.22	13.42 ± 7.34	45.68 ± 14.82	2.46 ± 1.82
After treatment		108.22 ± 15.11a,b	0.68 ± 0.14a,b	0.61 ± 0.18a,b	7.39 ± 6.78a,b	31.23 ± 17.07a,b	3.72 ± 2.14a,b
Control group	54
Before treatment		129.12 ± 15.28	0.59 ± 0.14	0.45 ± 0.23	13.97 ± 7.11	45.41 ± 15.35	2.55 ± 2.04
After treatment		114.59 ± 16.84a	0.65 ± 0.15a	0.58 ± 0.20a	8.72 ± 7.14a	34.65 ± 18.26a	3.47 ± 2.41a

^aP < 0.05 compared with before treatment.

^bP < 0.05 compared with the control group.

Table 4 Comparison of Tower of Hanoi test results between the combined group and the control group before and after treatment

	n	Total score	Average planning time (second)	Average execution time (second)
Combined group	56
Before treatment		42.87 ± 15.71	16.42 ± 9.54	29.76 ± 10.58
After treatment		64.75 ± 10.27a,b	8.62 ± 7.41a,b	22.79 ± 9.52a,b
Control group	54
Before treatment		43.16 ± 16.98	15.94 ± 10.08	29.41 ± 10.74
After treatment		61.23 ± 17.49a	9.76 ± 8.28a	24.35 ± 10.66a

^aP < 0.05 compared with before treatment.

^bP < 0.05 compared with the control group.

Table 5 Comparison of adverse reactions between the combined group and the control group, n (%)

Group	n	Postoperative dysphoria	Confusion of consciousness	Bradycardia	Headache	Muscle soreness	Bauseated	Emesis
Combined group	55	3 (5.45)	4 (7.27)	1 (1.82)	4 (7.27)	3 (5.45)	5 (9.09)	2 (3.64)
Control group	54	5 (9.26)	7 (12.96)	3 (5.56)	6 (11.11)	8 (14.81)	8 (14.81)	5 (9.26)
χ2		0.580	0.972	1.077	0.482	2.631	0.850	1.434
P value		0.446	0.324	0.299	0.488	0.105	0.357	0.231

Table 6 Comparison of long-term efficacy statistics between two groups of patients

	n	BRANS	MCCB	HAMD-24	WCST	TOH
Combined group	55	1.49 ± 0.49	1.16 ± 0.44	-0.54 ± 0.37	0.07 ± 0.02	1.28 ± 0.65
Control group	54	1.44 ± 0.52	1.12 ± 0.47	-0.52 ± 0.41	0.06 ± 0.02	1.25 ± 0.59
t value		0.182	0.106	0.124	0.085	0.127
P value		0.874	0.926	0.908	0.956	0.905

BRANS: Battery for the Assessment of Neuropsychological Status score; MCCB: Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery; HAMD-24: Hamilton Depression Scale-24; WCST: Wisconsin Card Sorting Test; TOH: Tower of Hanoi.