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Schuster H, Walters RW, Mathy J, Ramaswamy S, Alsakaf I. Correlation Between ECT Quality Measures and Likelihood to Transition From Acute to Continuation and Maintenance ECT. J ECT 2024:00124509-990000000-00171. [PMID: 38924479 DOI: 10.1097/yct.0000000000001028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
OBJECTIVES To evaluate the association between 3 ECT quality measures (seizure duration, Postictal Suppression Index [PSI], and heart rate response) and therapeutic compliance as indicated by transitioning from acute to continuation to maintenance phases of ECT. METHODS This was a retrospective chart review of patients who received ECT between July 2016 and July 2019. ECT quality measures were lagged by 1 ECT session to examine the effect of the prior session's quality measure on progressing to a higher ECT phase at the subsequent ECT session. Associations with therapeutic compliance were analyzed using mixed-effects ordinal regression and mixed-effects partial proportional odds models. RESULTS Seizure duration was associated with 8% higher adjusted odds of progressing to out of the acute phase (95% confidence interval [CI]: 2% to 15%, P = 0.007) and 18% higher adjusted odds of progressing to the maintenance phase (95% CI: 10% to 28%, P < 0.001); PSI was associated with 9% higher adjusted odds of progressing out of the acute phase (95% CI: 3% to 16%, P = 0.005), whereas heart rate response was not statistically associated with therapeutic compliance. Greater therapeutic compliance was also associated with bilateral electrode placement and older age. CONCLUSIONS Longer seizure duration was associated with greater therapeutic compliance across all ECT phases, PSI was associated with progressing out of the acute phase, and heart rate response was not associated with therapeutic compliance. Our findings assist ECT psychiatrists in optimizing ECT quality measures to promote better compliance with ECT.
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Affiliation(s)
| | - Ryan W Walters
- Clinical Research and Public Health, School of Medicine, Creighton University, Omaha, NE; and
| | - Jacob Mathy
- University of South Dakota School of Medicine, Sioux Falls, SD
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López-Ilundain J, Prados AB, Enriquez ÁSR, Enguita-Germán M, Rosquil EU, Gil JL, Fábrega AM, Martinez de Zabarte Moraza E, Maughan AR, Yoldi-Murillo J. Does Lidocaine Shorten Seizure Duration in Electroconvulsive Therapy? PHARMACOPSYCHIATRY 2023; 56:197-203. [PMID: 37643731 DOI: 10.1055/a-2114-4327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is an effective short-term treatment for schizophrenia and depression, amongst other disorders. Lidocaine is typically added to reduce pain from intravenous propofol injection. However, depending on the dose used in the ECT setting, it can shorten seizure duration. The aim of this study was to investigate the effect of lidocaine dose on seizure duration. METHODS This retrospective, naturalistic cohort study included 169 patients treated with ECT. We examined 4714 ECT sessions with propofol or propofol plus lidocaine. Ictal quality was manually rated by visual inspection. The main outcome of this study was the relation of lidocaine with seizure duration after controlling for socio-demographic, ECT, and other anesthetic variables. RESULTS There was a significant negative association between lidocaine usage and seizure duration. Multivariate analyses showed that seizure duration was shortened by an average of 3.21 s in sessions with lidocaine. Moreover, in this subgroup, there was a significant negative dose-dependent association between lidocaine dose and seizure length. Complementarily, a significant positive association between preictal BIS and seizure length was found in the subgroup of sessions where preictal was used. CONCLUSIONS We provide additional evidence highlighting the importance of caution regarding lidocaine dosing due to the effect on seizure length in the ECT setting. It is advisable for clinicians to exercise caution when administering lidocaine regarding its dosing and seizure length in ECT settings. Future investigation is needed to assess causal relationships by studying certain vulnerable groups or employing other charge calculation techniques, such as the titration method.
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Affiliation(s)
- Jose López-Ilundain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Alejandro Ballesteros Prados
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba Mental Health Network, Araba Psychiatric Hospital, Vitoria-Gasteiz, Spain
| | - Ángela S Rosero Enriquez
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Mónica Enguita-Germán
- Navarrabiomed-HUN-UPNA, Unidad de Metodología. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | | | - Jose López Gil
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Ana Marmol Fábrega
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | | | | | - Javier Yoldi-Murillo
- Department of Anaesthesiology, Hospital Universitario de Navarra, Pamplona, Spain
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3
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田 树, 徐 桂, 杨 新, Paul BF, Alan W. [Effect of electroconvulsive therapy on brain functional network in major depressive disorder]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2023; 40:426-433. [PMID: 37380380 PMCID: PMC10307598 DOI: 10.7507/1001-5515.202201032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/30/2023] [Indexed: 06/30/2023]
Abstract
Electroconvulsive therapy (ECT) is an interventional technique capable of highly effective neuromodulation in major depressive disorder (MDD), but its antidepressant mechanism remains unclear. By recording the resting-state electroencephalogram (RS-EEG) of 19 MDD patients before and after ECT, we analyzed the modulation effect of ECT on the resting-state brain functional network of MDD patients from multiple perspectives: estimating spontaneous EEG activity power spectral density (PSD) using Welch algorithm; constructing brain functional network based on imaginary part coherence (iCoh) and calculate functional connectivity; using minimum spanning tree theory to explore the topological characteristics of brain functional network. The results show that PSD, functional connectivity, and topology in multiple frequency bands were significantly changed after ECT in MDD patients. The results of this study reveal that ECT changes the brain activity of MDD patients, which provides an important reference in the clinical treatment and mechanism analysis of MDD.
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Affiliation(s)
- 树香 田
- 河北工业大学 河北省生物电磁与神经工程重点实验室(天津 300401)Key Laboratory of Bioelectromagnetic and Neural Engineering of Hebei Province, Hebei University of Technology, Tianjin 300401, P. R. China
- 河北工业大学 天津市生物电工与智能健康重点实验室(天津 300401)Tianjin Key Laboratory of Bioelectricity and Intelligent Health, Hebei University of Technology, Tianjin 300401, P. R. China
- 河北工业大学 省部共建电工装备可靠性与智能化国家重点实验室(天津 300130 )State Key Laboratory of Reliability and Intelligence of Electrical Equipment, Hebei University of Technology, Tianjin 300130, P.R.China
- 北京大学 中国药物依赖性研究所(北京 100191)National Institute on Drug Dependence, Peking University, Beijing 100191, P.R. China
| | - 桂芝 徐
- 河北工业大学 河北省生物电磁与神经工程重点实验室(天津 300401)Key Laboratory of Bioelectromagnetic and Neural Engineering of Hebei Province, Hebei University of Technology, Tianjin 300401, P. R. China
- 河北工业大学 天津市生物电工与智能健康重点实验室(天津 300401)Tianjin Key Laboratory of Bioelectricity and Intelligent Health, Hebei University of Technology, Tianjin 300401, P. R. China
- 河北工业大学 省部共建电工装备可靠性与智能化国家重点实验室(天津 300130 )State Key Laboratory of Reliability and Intelligence of Electrical Equipment, Hebei University of Technology, Tianjin 300130, P.R.China
| | - 新生 杨
- 河北工业大学 河北省生物电磁与神经工程重点实验室(天津 300401)Key Laboratory of Bioelectromagnetic and Neural Engineering of Hebei Province, Hebei University of Technology, Tianjin 300401, P. R. China
- 河北工业大学 天津市生物电工与智能健康重点实验室(天津 300401)Tianjin Key Laboratory of Bioelectricity and Intelligent Health, Hebei University of Technology, Tianjin 300401, P. R. China
- 河北工业大学 省部共建电工装备可靠性与智能化国家重点实验室(天津 300130 )State Key Laboratory of Reliability and Intelligence of Electrical Equipment, Hebei University of Technology, Tianjin 300130, P.R.China
| | - B Fitzgerald Paul
- 河北工业大学 河北省生物电磁与神经工程重点实验室(天津 300401)Key Laboratory of Bioelectromagnetic and Neural Engineering of Hebei Province, Hebei University of Technology, Tianjin 300401, P. R. China
| | - Wang Alan
- 河北工业大学 河北省生物电磁与神经工程重点实验室(天津 300401)Key Laboratory of Bioelectromagnetic and Neural Engineering of Hebei Province, Hebei University of Technology, Tianjin 300401, P. R. China
- 河北工业大学 天津市生物电工与智能健康重点实验室(天津 300401)Tianjin Key Laboratory of Bioelectricity and Intelligent Health, Hebei University of Technology, Tianjin 300401, P. R. China
- 河北工业大学 省部共建电工装备可靠性与智能化国家重点实验室(天津 300130 )State Key Laboratory of Reliability and Intelligence of Electrical Equipment, Hebei University of Technology, Tianjin 300130, P.R.China
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4
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Cheng J, Ren Y, Gu Q, He Y, Wang Z. QEEG Biomarkers for ECT Treatment Response in Schizophrenia. Clin EEG Neurosci 2022; 53:499-505. [PMID: 34792399 DOI: 10.1177/15500594211058260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Electroconvulsive therapy (ECT) is a clinically effective treatment for schizophrenia (SZD). However, studies have shown that only about 50 to 80% of patients show response to ECT. To identify the most suitable patients for ECT, developing biomarkers predicting ECT response remains an important goal. This study aimed to explore the quantitative electroencephalography (QEEG) biomarkers to predict ECT efficacy. Methods: Thirty patients who met DSM-5 criteria for SZD and had been assigned to ECT were recruited. 32-lead Resting-EEG recordings were collected one hour before the initial ECT treatment. Positive and negative symptoms scale (PANSS) was assessed at baseline and after the eighth ECT session. EEG data were analyzed using mutual information. Results: In the brain network density threshold range of 0.05 to 0.2, the assortativity of the right temporal, right parietal, and right occipital cortex in the response group was significantly higher than that in the non-response group (p < .05) in the beta band. In the theta band, the left frontal, parietal, right occipital cortex, and central area assortativity were higher in the response group than in the non-response group (p < .05). Conclusions: QEEG might be a useful approach to identify the candidate biomarker for ECT in clinical practice.
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Affiliation(s)
- Jiayue Cheng
- 364236Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yanyan Ren
- 364236Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Qiumeng Gu
- 364236Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yongguang He
- Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China
| | - Zhen Wang
- 364236Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.,Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China
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5
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Multimodal multi-center analysis of electroconvulsive therapy effects in depression: Brainwide gray matter increase without functional changes. Brain Stimul 2022; 15:1065-1072. [DOI: 10.1016/j.brs.2022.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/20/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022] Open
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Scangos KW, Khambhati AN, Daly PM, Owen LW, Manning JR, Ambrose JB, Austin E, Dawes HE, Krystal AD, Chang EF. Distributed Subnetworks of Depression Defined by Direct Intracranial Neurophysiology. Front Hum Neurosci 2021; 15:746499. [PMID: 34744662 PMCID: PMC8566975 DOI: 10.3389/fnhum.2021.746499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/02/2021] [Indexed: 12/30/2022] Open
Abstract
Major depressive disorder is a common and disabling disorder with high rates of treatment resistance. Evidence suggests it is characterized by distributed network dysfunction that may be variable across patients, challenging the identification of quantitative biological substrates. We carried out this study to determine whether application of a novel computational approach to a large sample of high spatiotemporal resolution direct neural recordings in humans could unlock the functional organization and coordinated activity patterns of depression networks. This group level analysis of depression networks from heterogenous intracranial recordings was possible due to application of a correlational model-based method for inferring whole-brain neural activity. We then applied a network framework to discover brain dynamics across this model that could classify depression. We found a highly distributed pattern of neural activity and connectivity across cortical and subcortical structures that was present in the majority of depressed subjects. Furthermore, we found that this depression signature consisted of two subnetworks across individuals. The first was characterized by left temporal lobe hypoconnectivity and pathological beta activity. The second was characterized by a hypoactive, but hyperconnected left frontal cortex. These findings have applications toward personalization of therapy.
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Affiliation(s)
- Katherine Wilson Scangos
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Ankit N. Khambhati
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Patrick M. Daly
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Lucy W. Owen
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States
| | - Jeremy R. Manning
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States
| | - Josiah B. Ambrose
- Kaiser Permanente Redwood City Medical Center, Redwood City, CA, United States
| | - Everett Austin
- Kaiser Permanente Redwood City Medical Center, Redwood City, CA, United States
| | - Heather E. Dawes
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Andrew D. Krystal
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Edward F. Chang
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
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7
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Changes in seizure duration during acute course electroconvulsive therapy. Brain Stimul 2021; 14:941-946. [PMID: 34119670 DOI: 10.1016/j.brs.2021.05.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/30/2021] [Accepted: 05/19/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Seizure duration has long been measured as a potential marker of ECT treatment efficacy, with concern that short seizures may be clinically ineffective. Relatively small studies have documented a trend towards shorter seizures during acute course ECT, but data from large cohorts would help provide normative data on seizure duration changes during treatment. OBJECTIVE This study analyzes the effects of age, sex, ECT dose, and treatment number on the duration of electrographic seizures during acute course ECT in a large single-center cohort. METHODS A single-center retrospective chart review was conducted of adult patients receiving a first course of ECT from 2000 to 2017 at a large freestanding psychiatric hospital. RESULTS 3648 patients met inclusion criteria, receiving 32,879 acute course ECT treatments. There was a shortening of mean ECT seizure duration over the acute course, with the greatest decrease in duration over the first 3 treatments but continuing decreases over the entire acute course. Older age, higher ECT dose, and increasing treatment number were all associated with shorter seizures, while sex was not significantly associated. Increasing treatment dose was associated with shorter seizures relative to no dose increase, with those patients receiving the highest cumulative doses also having the shortest cumulative seizure time. CONCLUSIONS Among patients undergoing acute-course ECT treatment, seizure duration decreased over the treatment course, and increases in applied electrical charge were associated with shorter seizures.
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Durmaz O, Öcek Baş T. An Observational Retrospective Study Investigating Changes in Seizure Adequacy Parameters of Electroconvulsive Therapy and Their Relationships to Clinical Outcome in Schizophrenia and Schizoaffective Disorder. Clin EEG Neurosci 2021; 52:168-174. [PMID: 32525703 DOI: 10.1177/1550059420932076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the current study was to investigate a possible relationship between electroconvulsive therapy (ECT) seizure adequacy parameters and clinical outcome as well as differences between ECT responders and nonresponders in terms of ECT seizure parameters in patients diagnosed with schizophrenia and schizoaffective disorder. First and last ECT records data, sociodemographic variables, and baseline and post ECT Positive and Negative Syndrome Scale scores were obtained. Maximum sustained power was higher in last ECT in favor of responders while peak heart rate was higher in ECT nonresponders than responders in first ECT. Stimulus doses were higher in last ECT than in the first ECT in both groups. No predictor variable was observed among baseline ECT seizure parameters for clinical improvement. Study was insufficient to yield a precise finding pointing a relationship between electrophysiological seizure parameters and clinical outcome in schizophrenia and schizoaffective disorder.
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Affiliation(s)
- Onur Durmaz
- Department of Psychiatry, 147010Erenköy Mental Health and Neurology Training & Research Hospital, Istanbul, Turkey
| | - Tuba Öcek Baş
- Department of Psychiatry, 147010Erenköy Mental Health and Neurology Training & Research Hospital, Istanbul, Turkey
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9
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Simon L, Blay M, Galvao F, Brunelin J. Using EEG to Predict Clinical Response to Electroconvulsive Therapy in Patients With Major Depression: A Comprehensive Review. Front Psychiatry 2021; 12:643710. [PMID: 34248695 PMCID: PMC8264052 DOI: 10.3389/fpsyt.2021.643710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/18/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: An important approach to improve the therapeutic effect of electroconvulsive therapy (ECT) may be to early characterize patients who are more likely to respond. Our objective was to explore whether baseline electroencephalography (EEG) settings before the beginning of ECT treatment can predict future clinical response to ECT in patients with depressive disorder. Methods: We conducted a systematic search in the MEDLINE, EMBASE, PsycINFO, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify studies using EEG in adults with depressive disorder treated by ECT. To investigate the predictive value of baseline EEG on clinical outcomes of ECT, we extracted from the retrieved studies and qualitatively described the association between the baseline EEG markers characteristics and the rates of future responders and/or remitters to ECT. Results: The primary search yielded 2,531 potentially relevant citations, and 12 articles were selected according to inclusion criteria. Most of the studies were prospective studies with small sample size. Sociodemographic and clinical characteristics of patients, ECT settings, EEG settings, and outcomes were heterogeneous. Event-related potential (ERP) paradigms were used in three studies, polysomnography was used in three studies, and the six other studies used EEG to measure cerebral connectivity and activity. Conclusions: P300 amplitude, coherence, and connectivity measures were correlated with remission in patients with depression treated by ECT. Sleep EEG recordings seemed not to be correlated with remission after ECT. Further prospective studies with large sample size are needed to determine optimal EEG parameters associated with clinical response to ECT in depressive disorder. Systematic Review Registration: PROSPERO CRD42020181978.
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Affiliation(s)
- Louis Simon
- Centre Hospitalier Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Lyon, France.,Lyon University, Université Lyon 1, Villeurbanne, France
| | - Martin Blay
- Centre Hospitalier Le Vinatier, Bron, France.,Lyon University, Université Lyon 1, Villeurbanne, France
| | | | - Jerome Brunelin
- Centre Hospitalier Le Vinatier, Bron, France.,INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, PSYR2 Team, Lyon, France.,Lyon University, Université Lyon 1, Villeurbanne, France
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10
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Luccarelli J, McCoy TH, Seiner SJ, Henry ME. Maintenance ECT is associated with sustained improvement in depression symptoms without adverse cognitive effects in a retrospective cohort of 100 patients each receiving 50 or more ECT treatments. J Affect Disord 2020; 271:109-114. [PMID: 32479305 PMCID: PMC7289157 DOI: 10.1016/j.jad.2020.03.152] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/19/2020] [Accepted: 03/29/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is the most effective acute treatment for depression, but relapse is common following discontinuation. One strategy for prolonging remission is the use of maintenance ECT, but the clinical evidence supporting its efficacy and safety are limited. We examined the effects of maintenance ECT on depression and cognition. METHODS Participants were from a retrospective cohort of 100 patients receiving ECT at a freestanding psychiatric hospital and who received at least 50 treatments during a single treatment series. QIDS, BASIS-24, and MoCA were assessed at baseline and every 10 treatments thereafter during the clinical course. RESULTS ECT was associated with a rapid decrease in depression symptoms and overall self-reported mental health status within the first 10 treatments, which was sustained throughout a median of 22.1 months of follow-up. There was no change in cognitive functioning as measured by the MoCA. Bilateral and brief pulse treatment parameters were more common by treatment 50 than at the first treatment. Most participants either continued in ECT at the end of the study period or discontinued due to sustained remission. LIMITATIONS retrospective observational study without control group who did not receive ECT. CONCLUSIONS In this ECT cohort with at least 50 treatments, improvement in depression was sustained on QIDS and BASIS-24 and adverse cognitive effects were not detected by serial MoCAs, supporting the utility of maintenance ECT in this cohort.
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Affiliation(s)
- James Luccarelli
- Department of Psychiatry, Massachusetts General Hospital, Boston (Luccarelli, Henry, McCoy); Department of Psychiatry, McLean Hospital, Belmont (Seiner).
| | | | | | - Michael E. Henry
- Department of Psychiatry, Massachusetts General Hospital, Boston (Luccarelli, Henry, McCoy); Department of Psychiatry, McLean Hospital, Belmont (Seiner)
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Sari Gokten E, Tulay EE, Beser B, Elagoz Yuksel M, Arikan K, Tarhan N, Metin B. Predictive Value of Slow and Fast EEG Oscillations for Methylphenidate Response in ADHD. Clin EEG Neurosci 2019; 50:332-338. [PMID: 31304784 DOI: 10.1177/1550059419863206] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder and is characterized by symptoms of inattention and/or hyperactivity and impulsivity. In the current study, we obtained quantitative EEG (QEEG) recordings of 51 children aged between 6 and 12 years before the initiation of methylphenidate treatment. The relationship between changes in the scores of ADHD symptoms and initial QEEG features (power/power ratios values) were assessed. In addition, the children were classified as responder and nonresponder according to the ratio of their response to the medication (>25% improvement after medication). Logistic regression analyses were performed to analyze the accuracy of QEEG features for predicting responders. The findings indicate that patients with increased delta power at F8, theta power at Fz, F4, C3, Cz, T5, and gamma power at T6 and decreased beta powers at F8 and P3 showed more improvement in ADHD hyperactivity symptoms. In addition, increased delta/beta power ratio at F8 and theta/beta power ratio at F8, F3, Fz, F4, C3, Cz, P3, and T5 showed negative correlations with Conners' score difference of hyperactivity as well. This means, those with greater theta/beta and delta/beta powers showed more improvement in hyperactivity following medication. Theta power at Cz and T5 and theta/beta power ratios at C3, Cz, and T5 have significantly classified responders and nonresponders according to the logistic binary regression analysis. The results show that slow and fast oscillations may have predictive value for treatment response in ADHD. Future studies should seek for more sensitive biomarkers.
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Affiliation(s)
- Emel Sari Gokten
- 1 Department of Child and Adolescent Psychiatry, NPIstanbul Brain Hospital, Istanbul, Turkey
| | - Emine Elif Tulay
- 2 Technology Transfer Office, Uskudar University, Istanbul, Turkey
| | - Birsu Beser
- 3 Neuroscience Department, Istanbul University, Istanbul, Turkey
| | - Mine Elagoz Yuksel
- 1 Department of Child and Adolescent Psychiatry, NPIstanbul Brain Hospital, Istanbul, Turkey
| | - Kemal Arikan
- 4 Department of Psychology, Faculty of Humanities and Social Sciences, Uskudar University, Istanbul, Turkey
| | - Nevzat Tarhan
- 4 Department of Psychology, Faculty of Humanities and Social Sciences, Uskudar University, Istanbul, Turkey.,5 Department of Psychiatry, NPIstanbul Brain Hospital, Istanbul, Turkey
| | - Baris Metin
- 4 Department of Psychology, Faculty of Humanities and Social Sciences, Uskudar University, Istanbul, Turkey
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