Antidepressant effects, of magnetic seizure therapy and electroconvulsive therapy, in treatment-resistant depression

Kayser, Sarah; Bewernick, Bettina H.; Grubert, Christiane; Hadrysiewicz, B.; Axmacher, Nikolai; Schläepfer, Thomas E.

doi:10.1016/j.jpsychires.2010.09.008

Cited by 163 publications

(180 citation statements)

References 63 publications

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“…Various neuroantomical structures have been used as targets for DBS including subgenual cingulate cortex (SCC) (Holtzheimer and Mayberg, 2010;Lozano et al, 2008;Neimat et al, 2008), ventral capsule/ventral striatum (Malone et al, 2009), nucleus accumbens (Kayser et al, 2011;Schlaepfer et al, 2008), inferior thalamic peduncle (Jimenez et al, 2005) and lateral habenula (Sartorius et al, 2010). A recent pilot study also assessed the safety and efficacy of DBS to the supero-lateral branch of the medial forebrain bundle in seven patients with highly refractory depression (Schlaepfer et al, 2013) with promising results.…”

Section: Introductionmentioning

confidence: 99%

EEG Power Asymmetry and Functional Connectivity as a Marker of Treatment Effectiveness in DBS Surgery for Depression

Quraan

Protzner

Daskalakis

et al. 2013

Neuropsychopharmacol

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Recently, deep brain stimulation (DBS) has been evaluated as an experimental therapy for treatment-resistant depression. Although there have been encouraging results in open-label trials, about half of the patients fail to achieve meaningful benefit. Although progress has been made in understanding the neurobiology of MDD, the ability to characterize differences in brain dynamics between those who do and do not benefit from DBS is lacking. In this study, we investigated EEG resting-state data recorded from 12 patients that have undergone DBS surgery. Of those, six patients were classified as responders to DBS, defined as an improvement of 50% or more on the 17-item Hamilton Rating Scale for Depression (HAMD-17). We compared hemispheric frontal theta and parietal alpha power asymmetry and synchronization asymmetry between responders and non-responders. Hemispheric power asymmetry showed statistically significant differences between responders and non-responders with healthy controls showing an asymmetry similar to responders but opposite to non-responders. This asymmetry was characterized by an increase in frontal theta in the right hemisphere relative to the left combined with an increase in parietal alpha in the left hemisphere relative to the right in non-responders compared with responders. Hemispheric mean synchronization asymmetry showed a statistically significant difference between responders and non-responders in the theta band, with healthy controls showing an asymmetry similar to responders but opposite to non-responders. This asymmetry resulted from an increase in frontal synchronization in the right hemisphere relative to the left combined with an increase in parietal synchronization in the left hemisphere relative to the right in non-responders compared with responders. Connectivity diagrams revealed long-range differences in frontal/central-parietal connectivity between the two groups in the theta band. This pattern was observed irrespective of whether EEG data were collected with active DBS or with the DBS stimulation turned off, suggesting stable functional and possibly structural modifications that may be attributed to plasticity.

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Section: Introductionmentioning

confidence: 99%

EEG Power Asymmetry and Functional Connectivity as a Marker of Treatment Effectiveness in DBS Surgery for Depression

Quraan

Protzner

Daskalakis

et al. 2013

Neuropsychopharmacol

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“…In these studies, the response rates were 38% and 69%, and the remission rates were 15% and 46%, respectively. A sub-component of the latter study compared MST with right unilateral (RUL) ECT at 3 × ST in 20 patients, and found no significant differences in efficacy (Kayser et al, 2011). This study reported low cognitive side effects in both ECT and MST groups, with faster reorientation following MST.…”

Section: Introductionmentioning

confidence: 82%

Individualized Low-Amplitude Seizure Therapy: Minimizing Current for Electroconvulsive Therapy and Magnetic Seizure Therapy

Peterchev

Krystal

Rosa³

et al. 2015

Neuropsychopharmacol

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Electroconvulsive therapy (ECT) at conventional current amplitudes (800-900 mA) is highly effective but carries the risk of cognitive side effects. Lowering and individualizing the current amplitude may reduce side effects by virtue of a less intense and more focal electric field exposure in the brain, but this aspect of ECT dosing is largely unexplored. Magnetic seizure therapy (MST) induces a weaker and more focal electric field than ECT; however, the pulse amplitude is not individualized and the minimum amplitude required to induce a seizure is unknown. We titrated the amplitude of long stimulus trains (500 pulses) as a means of determining the minimum current amplitude required to induce a seizure with ECT (bilateral, right unilateral, bifrontal, and frontomedial electrode placements) and MST (round coil on vertex) in nonhuman primates. Furthermore, we investigated a novel method of predicting this amplitude-titrated seizure threshold (ST) by a non-convulsive measurement of motor threshold (MT) using single pulses delivered through the ECT electrodes or MST coil. Average STs were substantially lower than conventional pulse amplitudes (112-174 mA for ECT and 37.4% of maximum device amplitude for MST). ST was more variable in ECT than in MST. MT explained 63% of the ST variance and is hence the strongest known predictor of ST. These results indicate that seizures can be induced with less intense electric fields than conventional ECT that may be safer; efficacy and side effects should be evaluated in clinical studies. MT measurement could be a faster and safer alternative to empirical ST titration for ECT and MST.

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“…There was no signifi cant difference in anti-depressant response between the two treatment groups, and cognitive side effects were not observed in either group. Whilst this was a small study, the positive results in favour of MST suggest that it may be a useful alternative to ECT if effi cacy and safety data can be confi rmed (Kayser et al, 2011).…”

Section: What Progress Has Been Made Towards Clinical Use Of Mst?mentioning

confidence: 90%

“…Most recently was a randomized study of 20 patients with treatment resistant depression who received either ECT or MST (stimulation frequency 100 Hz; train duration up to 6 s) (Kayser et al, 2011). Using 100 Hz, there was seizure induction in all patients; in the MST group, six out of 10 were classifi ed as responders (50% reduction of the MADRS score) and three of these reached remission status (MADRS score of less than 10).…”

Section: What Progress Has Been Made Towards Clinical Use Of Mst?mentioning

confidence: 99%

“…They continue to be a crucial driver for attempts to fi nd alternative physical treatments which may provide equivalent (or superior) effi cacy, with lower cognitive side effects (Fitzgerald, 2008). In magnetic seizure therapy (MST) a coil is used to generate high frequency (100 Hz), repetitive trans-cranial magnetic stimulation (rTMS) (Kayser et al, 2011;Morales et al, 2004;Rowny et al, 2009). This leads to depolarization of neurons, causing focal induction of a generalized seizure.…”

Section: Introductionmentioning

confidence: 99%

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The Use of ECT and MST in treating depression

Allan

Ebmeier

2011

International Review of Psychiatry

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Electroconvulsive therapy (ECT) has been used clinically since 1938. Its most common use is in the treatment of depression: fi rst line treatment where rapid recovery is a priority, but more frequently as an effective treatment for patients who do not respond to pharmacological and psychological approaches. Whilst it is widely hailed as an effective treatment, concerns about its effect on cognition remain. The development of magnetic seizure therapy (MST) over the past decade has attempted to devise a therapy with comparable effi cacy to ECT, but without the associated cognitive side effects. The rationale for this is that MST uses magnetic fi elds to induce seizures in the cortex, without electrical stimulation of brain structures involved with memory. MST has been used successfully in the treatment of depression, yet there is a dearth of literature in comparison with ECT. We present a systematic review of the literature on ECT (from 2009ECT (from -2011 and MST (from 2001MST (from -2011.

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Antidepressant effects, of magnetic seizure therapy and electroconvulsive therapy, in treatment-resistant depression

Cited by 163 publications

References 63 publications

EEG Power Asymmetry and Functional Connectivity as a Marker of Treatment Effectiveness in DBS Surgery for Depression

EEG Power Asymmetry and Functional Connectivity as a Marker of Treatment Effectiveness in DBS Surgery for Depression

Individualized Low-Amplitude Seizure Therapy: Minimizing Current for Electroconvulsive Therapy and Magnetic Seizure Therapy

The Use of ECT and MST in treating depression

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