Electric field strength induced by electroconvulsive therapy is associated with clinical outcome

Friðgeirsson, Egill A.; Deng, Zhi‐De; Denys, Damiaan; Waarde, Jeroen A. van; Wingen, Guido A. van

doi:10.1016/j.nicl.2021.102581

Cited by 27 publications

(28 citation statements)

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“…We found that regional EF strength, which is a proxy for the effect of direct electrical stimulation rather than the seizure activity, was the highest in the brain regions near the stimulus electrodes (i.e., GM of the right pre/post central gyrus and the right superior temporal gyrus with the greatest magnitude in the adjacent WM), in line with a previous study [49]. The regional EF was strongly correlated with the Euclidean distance from these brain regions (supplementary figure 3), but not with the regional volume change when analyzing the ROIs in each hemisphere separately.…”

Section: Discussionsupporting

confidence: 92%

“…Patients who did not respond to RUL ECT by the sixth session were switched to bitemporal ECT (n = 5). These patients were excluded from this study to ensure sample homogeneity because EF distribution is related to electrode placement [49]. Etomidate (0.2mg/kg) was used for general anesthesia, and succinylcholine (1 mg/kg) was used to induce muscle relaxation.…”

Section: Ect Proceduresmentioning

confidence: 99%

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Biophysical mechanisms of electroconvulsive therapy-induced volume expansion in the medial temporal lobe: a longitudinal in vivo human imaging study

Takamiya

Bouckaert

Laroy

et al. 2021

Preprint

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BackgroundElectroconvulsive therapy (ECT) applies electric currents to the brain to induce seizures for therapeutic purposes. ECT increases gray matter (GM) volume, predominantly in the medial temporal lobe (MTL). The contribution of induced seizures to this volume change remains unclear.MethodsT1-weighted structural MRI was acquired from thirty patients with late-life depression (mean age 72.5±7.9 years, 19 female), before and one week after one course of right unilateral ECT. Whole brain voxel-/deformation-/surface-based morphometry analyses were conducted to identify tissue-specific (GM, white matter: WM), and cerebrospinal fluid (CSF) and cerebral morphometry changes following ECT. Whole-brain voxel-wise electric field (EF) strength was estimated to investigate the association of EF distribution and regional brain volume change. The association between percentage volume change in the right MTL and ECT-related parameters (seizure duration, EF, and number of ECT sessions) was investigated using multiple regression.ResultsECT induced widespread GM volume expansion with corresponding contraction in adjacent CSF compartments, and limited WM change. The regional EF was strongly correlated with the distance from the electrodes, but not with regional volume change. The largest volume expansion was identified in the right MTL, and this was correlated with the total seizure duration.ConclusionsRight unilateral ECT induces widespread, bilateral regional volume expansion and contraction, with the largest change in the right MTL. This dynamic volume change cannot be explained by the effect of electrical stimulation alone and is related to the cumulative effect of ECT-induced seizures.

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Section: Discussionsupporting

confidence: 92%

Section: Ect Proceduresmentioning

confidence: 99%

Biophysical mechanisms of electroconvulsive therapy-induced volume expansion in the medial temporal lobe: a longitudinal in vivo human imaging study

Takamiya

Bouckaert

Laroy

et al. 2021

Preprint

Self Cite

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show abstract

Section: Effect Of Electrical Stimulation On Regional Volume Change Following Ectsupporting

confidence: 91%

“…Patients who did not respond to RUL ECT by the sixth session were switched to bitemporal ECT (n = 5). These patients were excluded from this study to ensure sample homogeneity because EF distribution is related to electrode placement [ 49 ]. Etomidate (0.2 mg/kg) was used for general anesthesia, and succinylcholine (1 mg/kg) was used to induce muscle relaxation.…”

Section: Methodsmentioning

confidence: 99%

Biophysical mechanisms of electroconvulsive therapy-induced volume expansion in the medial temporal lobe: A longitudinal in vivo human imaging study

et al. 2021

Self Cite

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Background: Electroconvulsive therapy (ECT) applies electric currents to the brain to induce seizures for therapeutic purposes. ECT increases gray matter (GM) volume, predominantly in the medial temporal lobe (MTL). The contribution of induced seizures to this volume change remains unclear. Methods: T1-weighted structural MRI was acquired from thirty patients with late-life depression (mean age 72.5 ± 7.9 years, 19 female), before and one week after one course of right unilateral ECT. Whole brain voxel-/deformation-/surface-based morphometry analyses were conducted to identify tissue-specific (GM, white matter: WM), and cerebrospinal fluid (CSF) and cerebral morphometry changes following ECT. Whole-brain voxel-wise electric field (EF) strength was estimated to investigate the association of EF distribution and regional brain volume change. The association between percentage volume change in the right MTL and ECT-related parameters (seizure duration, EF, and number of ECT sessions) was investigated using multiple regression. Results: ECT induced widespread GM volume expansion with corresponding contraction in adjacent CSF compartments, and limited WM change. The regional EF was strongly correlated with the distance from the electrodes, but not with regional volume change. The largest volume expansion was identified in the right MTL, and this was correlated with the total seizure duration. Conclusions: Right unilateral ECT induces widespread, bilateral regional volume expansion and contraction, with the largest change in the right MTL. This dynamic volume change cannot be explained by the effect of electrical stimulation alone and is related to the cumulative effect of ECT-induced seizures.

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“…These deviations in ECT‐induced seizures are partially explained by differences in stimulation technique (RUL vs BL electrode placement) and anatomical differences between patients. 46 Another explanation for the differences in seizure onset zones is that certain brain regions do not seem to be involved in seizures of epilepsy and ECT patients. This questions the use of the term “generalization” as parts of the brain may be spared.…”

Section: Discussionmentioning

confidence: 99%

Seizures induced in electroconvulsive therapy as a human epilepsy model: A comparative case study

et al. 2021

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Electric field strength induced by electroconvulsive therapy is associated with clinical outcome

Cited by 27 publications

References 50 publications

Biophysical mechanisms of electroconvulsive therapy-induced volume expansion in the medial temporal lobe: a longitudinal in vivo human imaging study

Biophysical mechanisms of electroconvulsive therapy-induced volume expansion in the medial temporal lobe: a longitudinal in vivo human imaging study

Biophysical mechanisms of electroconvulsive therapy-induced volume expansion in the medial temporal lobe: A longitudinal in vivo human imaging study

Seizures induced in electroconvulsive therapy as a human epilepsy model: A comparative case study

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