Seizure (Ictal)—EEG Characteristics in Subgroups of Depressive Disorder in Patients Receiving Electroconvulsive Therapy (ECT)—A Preliminary Study and Multivariate Approach

Wahlund, Björn; Piazza, Paolo; Rosen, Dietrich von; Liberg, Benny; Liljenström, Hans

doi:10.1155/2009/965209

Cited by 11 publications

(4 citation statements)

References 22 publications

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“…This is followed by rhythmic slow waves with a definite endpoint. Wahlund et al (2009) examined frequency distributions of ictal EEG after ECT stimulation in diagnostic subgroups of depression. Psychotic depression has a high occurrence of delta and theta waves, unipolar depression has a high occurrence of delta, theta and gamma waves, and bipolar depression has a high occurrence of gamma waves (accuracy 94%).…”

Section: Electroconvulsive Therapymentioning

confidence: 99%

EEG in psychiatric practice: to do or not to do?

Badrakalimuthu¹,

Swamiraju²,

Waal³

2011

Adv. psychiatr. treat

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SummaryElectroencephalography (EEG) is a non-invasive investigation that can aid the diagnosis of psychiatric and neuropsychiatric disorders. A good predictor of an abnormal EEG recording is the presence of an organic factor identified during the clinical assessment. The non-invasiveness and low cost of the procedure and its ability to measure spontaneous brain activity appear to attract clinicians to utilise this investigative tool. However, studies have reported that EEGs arising from psychiatric referrals have the lowest abnormality detection rate. The focus of this article is to improve this by highlighting the current pitfalls and providing recommendations for appropriate utilisation of EEG. We describe specific EEG changes associated with major psychiatric disorders. We conclude by offering pragmatic considerations when referring a patient for EEG, emphasising the fact that the information provided to the neurophysiologist plays a crucial role in interpreting the EEG recording in a diagnostically meaningful way.

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Section: Electroconvulsive Therapymentioning

confidence: 99%

EEG in psychiatric practice: to do or not to do?

Badrakalimuthu¹,

Swamiraju²,

Waal³

2011

Adv. psychiatr. treat

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“…Spectral analyses have dominated the majority of early research involving ECT, with previous studies revealing predominantly delta activity during seizures and much smaller peaks in the gamma band (Wahlund et al ., 2009). Gamma oscillations have become a predominant area of interest in multiple fields of study, including epilepsy (Benedek et al ., 2016) and depression (Fitzgerald and Watson, 2018).…”

Section: Discussionmentioning

confidence: 99%

Central-positive complexes in ECT-induced seizures: Evidence for thalamocortical mechanisms

Huels

Hickman

Ching

et al. 2020

Preprint

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Electroconvulsive therapy (ECT) relies on the electrical induction of generalized seizures to treat major depressive disorder and other psychiatric illnesses. These planned procedures provide a clinically relevant model system for studying neurophysiologic characteristics of generalized seizures. We recently described novel central-positive complexes (CPCs), which were observed during ECT-induced seizures as generalized, high-amplitude waveforms with maximum positive voltage over the vertex. Here, we performed a systematic characterization of 6,928 CPC ictal waveforms recorded in 11 patients undergoing right unilateral (RUL) ECT. Analyses of high-density 65-electrode EEG recordings during these 50 seizures allowed evaluation of these CPCs across temporal, spatial, and spectral domains. Peak-amplitude CPC scalp topology was consistent across seizures, showing maximal positive polarity over the midline fronto-central region and maximal negative polarity over the suborbital regions. Total duration of CPCs positively correlated with the time required for return of responsiveness after ECT treatment (r = 0.39, p = 0.005). The rate of CPCs showed a frequency decline consistent with an exponential decay (median 0.032 (IQR 0.053) complexes/second). Gamma band (30-80 Hz) oscillations correlated with the peak amplitude of CPCs, which was also reproducible across seizures, with band power declining over time (r = -0.32, p < 10-7). The sources of these peak potentials were localized to the bilateral medial thalamus and cingulate cortical regions. Our findings demonstrated CPC characteristics that were invariant to participant, stimulus charge, time, and agent used to induce general anesthesia during the procedure. Consistent with ictal waveforms of other generalized epilepsy syndromes, CPCs showed topographic distribution over the fronto-central regions, predictable intra-seizure frequency decline, and correlation with gamma-range frequencies. Furthermore, source localization to the medial thalamus was consistent with underlying thalamocortical pathophysiology, as established in generalized epilepsy syndromes. The consistency and reproducibility of CPCs offers a new avenue for studying the dynamics of seizure activity and thalamocortical networks.

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“…These differences in the EEG characteristics fade out with application of ECT. 25) A recent study by Zhao et al . 26) revealed decrease in alpha activity in the fronto-temporal cortex following a series of ECT.…”

Section: Main Subjectsmentioning

confidence: 98%

How Electroconvulsive Therapy Works?: Understanding the Neurobiological Mechanisms

Singh

Kar

2017

Clin Psychopharmacol Neurosci

144

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Electroconvulsive therapy (ECT) is a time tested treatment modality for the management of various psychiatric disorders. There have been a lot of modifications in the techniques of delivering ECT over decades. Despite lots of criticisms encountered, ECT has still been used commonly in clinical practice due to its safety and efficacy. Research evidences found multiple neuro-biological mechanisms for the therapeutic effect of ECT. ECT brings about various neuro-physiological as well as neuro-chemical changes in the macro- and micro-environment of the brain. Diverse changes involving expression of genes, functional connectivity, neurochemicals, permeability of blood-brain-barrier, alteration in immune system has been suggested to be responsible for the therapeutic effects of ECT. This article reviews different neurobiological mechanisms responsible for the therapeutic efficacy of ECT.

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Seizure (Ictal)—EEG Characteristics in Subgroups of Depressive Disorder in Patients Receiving Electroconvulsive Therapy (ECT)—A Preliminary Study and Multivariate Approach

Cited by 11 publications

References 22 publications

EEG in psychiatric practice: to do or not to do?

EEG in psychiatric practice: to do or not to do?

Central-positive complexes in ECT-induced seizures: Evidence for thalamocortical mechanisms

How Electroconvulsive Therapy Works?: Understanding the Neurobiological Mechanisms

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