We report the case of a middle-aged woman with two spinal cord stimulators in situ for treatment of chronic back pain, whose Major Depressive Episode was safely and effectively treated with a course of bifrontal electrode placement, 1.0 ms pulse-width electroconvulsive therapy (ECT). To our knowledge, this is the first report of a patient with implanted spinal cord stimulators who was treated with ECT. Of significance, the ECTwas safe and effective in treating the patient’s depression. Spinal cord stimulation (SCS) is a neuromodulation technique used to treat various forms of treatment-refractory chronic back pain, particularly in failed back surgery syndrome (FBSS). SCS involves percutaneous or surgical implantation of electrodes in the epidural space, which are connected to a battery-powered implantable pulse generator (IPG). The stimulator delivers electrical pulses in pre-determined patterns established by parameters such as pulse-width, frequency and amplitude. Whilst its mechanisms of analgesic action are not well understood [1,2], increasing evidence from clinical trials support its analgesic efficacy in what can be a severely debilitating and distressing condition [1,3]. ECT is an antidepressant intervention which involves the passage of an electrical current through pre-determined electrode configurations placed on the recipient’s scalp to induce a seizure. Whilst a recent case report and literature review reported on the safety of ECT in patients with implanted deep brain stimulators (DBS) [4], there is no literature describing the feasibility, safety or efficacy of ECT applied to patients with implanted SCS. The patient was a 68-year-old married woman with a 40-year history of recurrent Major Depressive Disorder. Relatively high dose psychotropic medication regimens over adequate durations did not result in improvement of her most recent relapse over 18 months. On presentation, the patient reported severely low mood, anhedonia, low energy, poor motivation, diurnal variation with mood worst in the mornings, along with hopeless, helpless

中文翻译：

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用电惊厥疗法安全成功地治疗植入脊髓刺激器的患者的抑郁症

我们报告了一名中年妇女的案例，该患者使用两个脊髓刺激器原位治疗慢性背痛，其重度抑郁发作通过双额电极放置、1.0 ms 脉宽电休克疗法 (ECT) 安全有效地治疗）。据我们所知，这是第一份接受 ECT 治疗的植入脊髓刺激器的患者的报告。具有重要意义的是，ECT在治疗患者的抑郁症方面是安全有效的。脊髓刺激 (SCS) 是一种神经调节技术，用于治疗各种形式的难治性慢性背痛，尤其是背部手术失败综合征 (FBSS)。SCS 涉及在硬膜外腔中经皮或手术植入电极，这些电极连接到电池供电的植入式脉冲发生器 (IPG)。刺激器以由脉冲宽度、频率和幅度等参数建立的预定模式提供电脉冲。虽然其镇痛作用机制尚不清楚 [1,2]，但越来越多的临床试验证据支持其镇痛效果，可能会导致严重虚弱和痛苦的病症 [1,3]。ECT 是一种抗抑郁干预，它涉及电流通过放置在接受者头皮上的预定电极配置以诱发癫痫发作。虽然最近的病例报告和文献综述报告了 ECT 在植入深部脑刺激器 (DBS) 患者中的安全性 [4]，但没有文献描述 ECT 应用于植入 SCS 患者的可行性、安全性或有效性。患者是一位 68 岁的已婚妇女，有 40 年的重度抑郁症复发史。在足够的持续时间内，相对高剂量的精神药物治疗方案并未改善她最近 18 个月的复发。就诊时，患者报告情绪严重低落、快感缺乏、精力不足、动力不足、昼夜变化，早上情绪最差，以及绝望、无助