{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:49:25Z","timestamp":1782388165779,"version":"3.54.5"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neuropsychopharm Rep"],"published-print":{"date-parts":[[2026,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Tardive dystonia is a disabling tardive syndrome associated with exposure to dopamine receptor\u2010blocking agents. Responses to pharmacotherapy are often limited, and evidence supporting electroconvulsive therapy (ECT) remains sparse.<\/jats:p>\n <\/jats:sec>\n \n Case Presentation<\/jats:title>\n A woman in her early 60s with recurrent major depressive disorder (in full remission at presentation) developed progressive cervical\u2010truncal dystonia with tremor\u2010like involuntary movements after years of fluctuating psychotropic regimens that included exposure to antipsychotic medication. Neurologic evaluation, including brain magnetic resonance imaging and electroencephalography, was unremarkable, and no structural, metabolic, or neurodegenerative cause was identified from available records. Multiple pharmacologic strategies\u2014including anticholinergics, benzodiazepines, and valbenazine\u2014provided insufficient control, and she became wheelchair\u2010dependent. During a recent psychiatric admission, she received ECT primarily for refractory tardive dystonia. Severity was tracked using the Abnormal Involuntary Movement Scale (AIMS), which was 27 at admission and 25 immediately before ECT. After benzodiazepines were discontinued, she underwent an acute course of bitemporal ECT over approximately 6\u2009weeks under propofol (50\u2009mg) and succinylcholine (50\u2009mg) anesthesia, with a recorded stimulus charge of 100 mC and pulse width of 1.0\u2009ms. Seizure duration on electroencephalography ranged from 25 to 85\u2009s (motor 25\u201359\u2009s when recorded), and the device\/local\u2010record postictal suppression index was 1\u20132. Motor symptoms improved progressively; by the middle of the course, she no longer required a wheelchair and ambulated independently. The AIMS score decreased to 14 later in the course and remained 14 at completion of the acute course. However, dystonia gradually recurred after ECT discontinuation.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n ECT may provide clinically meaningful short\u2010term improvement in severe refractory tardive dystonia even in the absence of active depressive symptoms; relapse after acute treatment may occur, and continuation strategies may be required.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/npr2.70128","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:45:06Z","timestamp":1779169506000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Electroconvulsive Therapy for Severe Refractory Tardive Dystonia Without Active Depression: A Case Report"],"prefix":"10.1002","volume":"46","author":[{"given":"Tomohiro","family":"Asahi","sequence":"first","affiliation":[{"name":"Department of Psychiatry Dokkyo Medical University Tochigi, Shimotsuga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9879-9492","authenticated-orcid":false,"given":"Yasushi","family":"Kawamata","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Dokkyo Medical University Tochigi, Shimotsuga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7058-664X","authenticated-orcid":false,"given":"Norio","family":"Sugawara","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Dokkyo Medical University Tochigi, Shimotsuga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Maehara","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Dokkyo Medical University Tochigi, Shimotsuga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4414-3770","authenticated-orcid":false,"given":"Norio","family":"Yasui\u2010Furukori","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Dokkyo Medical University Tochigi, Shimotsuga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/dyst.2023.10957"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/17512433.2018.1429264"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S62490"},{"issue":"4","key":"e_1_2_13_5_1","first-page":"275","article-title":"Electroconvulsive Therapy in Tardive Dystonia","volume":"11","author":"Postolache T. T.","year":"1995","journal-title":"Convulsive Therapy"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.9758\/cpn.24.1185"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pcn5.70135"},{"key":"e_1_2_13_8_1","volume-title":"ECDEU Assessment Manual for Psychopharmacology\u2014Revised","author":"Guy W.","year":"1976"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/indianjpsychiatry.indianjpsychiatry_491_22"},{"key":"e_1_2_13_10_1","first-page":"797","article-title":"Electroconvulsive Shock and Dopamine Receptor Sensitivity","volume":"19","author":"Lerer B.","year":"1984","journal-title":"Biological Psychiatry"},{"key":"e_1_2_13_11_1","first-page":"654","article-title":"Role of Dopamine in the Mechanism of Action of Electroconvulsive Therapy","volume":"61","author":"Kapur S.","year":"1993","journal-title":"Journal of Neurochemistry"}],"container-title":["Neuropsychopharmacology Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/npr2.70128","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/npr2.70128","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/npr2.70128","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:23:34Z","timestamp":1782386614000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/npr2.70128"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,18]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/npr2.70128"],"URL":"https:\/\/doi.org\/10.1002\/npr2.70128","archive":["Portico"],"relation":{},"ISSN":["2574-173X","2574-173X"],"issn-type":[{"value":"2574-173X","type":"print"},{"value":"2574-173X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,18]]},"assertion":[{"value":"2026-01-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70128"}}