Factors Predicting Ictal Quality in Bilateral Electroconvulsive Therapy Sessions

In electroconvulsive therapy (ECT), ictal characteristics predict treatment response and can be modified by changes in seizure threshold and in the ECT technique. We aimed to study the impact of ECT procedure-related variables that interact during each session and might influence the seizure results. Two hundred and fifty sessions of bilateral ECT in forty-seven subjects were included. Seizure results were evaluated by two different scales of combined ictal EEG parameters (seizure quality index (SQI) and seizure adequacy markers sum (SAMS) scores) and postictal suppression rating. Repeated measurement regression analyses were performed to identify predictors of each session’s three outcome variables. Univariate models identified age, physical status, hyperventilation, basal oxygen saturation, days between sessions, benzodiazepines, lithium, and tricyclic antidepressants as predictors of seizure quality. Days elapsed between sessions, higher oxygen saturation and protocolized hyperventilation application were significant predictors of better seizure quality in both scales used in multivariate models. Additionally, lower ASA classification influenced SQI scores as well as benzodiazepine use and lithium daily doses were predictors of SAMS scores. Higher muscle relaxant doses and lower applied stimulus intensities significantly influenced the postictal suppression rating. The study found several modifiable procedural factors that impacted the obtained seizure characteristics; they could be adjusted to optimize ECT session results.

Download Full-text

Changes in Seizure Threshold Over the Course of Electroconvulsive Therapy Affect Therapeutic Response and Are Detected by Ictal EEG Ratings

Journal of Neuropsychiatry ◽

10.1176/jnp.10.2.178 ◽

1998 ◽

Vol 10 (2) ◽

pp. 178-186 ◽

Cited By ~ 63

Author(s):

Andrew D. Krystal ◽

C. Edward Coffey ◽

Richard D. Weiner ◽

Tracey Holsinger

Keyword(s):

Electroconvulsive Therapy ◽

Therapeutic Response ◽

Seizure Threshold ◽

Ictal Eeg

Download Full-text

Use of ultrabrief pulse width electroconvulsive therapy to induce therapeutic seizures in an elderly patient with a high seizure threshold: a case report

Australasian Psychiatry ◽

10.1177/1039856219889306 ◽

2019 ◽

Vol 28 (3) ◽

pp. 291-296

Author(s):

David Plevin ◽

Susan Waite

Keyword(s):

Case Report ◽

Electroconvulsive Therapy ◽

Pulse Width ◽

Depressive Illness ◽

Electrode Placement ◽

Seizure Threshold ◽

Augmentation Strategies ◽

Seizure Quality ◽

Unipolar Major Depression

Objective: This case report describes a 73-year-old man suffering from unipolar major depression with melancholic features, in whom treatment with electroconvulsive therapy (ECT) proved difficult due to inadequate seizure generation. Methods: A number of augmentation strategies were trialled in an attempt to improve seizure quality. Pre-ECT and Post-ECT measurement of symptoms, quality of life and cognition were undertaken with a variety of validated scales. Results: The single most efficacious strategy to elicit therapeutic seizures was the use of right unilateral (RUL) electrode placement with an ultrabrief pulse width. The patient subsequently had a resolution of his depressive illness, with a concomitant improvement in cognitive functioning. Conclusion: This case demonstrates that a number of ECT augmentation strategies can be used in routine clinical practice for patients with high seizure thresholds. It highlights that UB pulse width may be considered earlier in the treatment course for patients in whom conventional brief pulse ECT fails to generate effective seizures.

Download Full-text

The Impact of Music Therapy Sessions on Children Diagnosed with Progressive Chronic Illness – a Pilot Program

Studia Universitatis Babeş-Bolyai Musica ◽

10.24193/subbmusica.2018.2.08 ◽

2018 ◽

Vol 63 (2) ◽

pp. 85-102

Author(s):

Lois Văduva ◽

◽

Annamaria Balla ◽

Keyword(s):

Chronic Illness ◽

Music Therapy ◽

Pilot Program ◽

The Impact ◽

Therapy Sessions

Download Full-text

Successful electroconvulsive therapy for depression in a man with cerebral amyloid angiopathy

BMJ Case Reports ◽

10.1136/bcr-2020-238922 ◽

2021 ◽

Vol 14 (2) ◽

pp. e238922

Author(s):

Geert Schurgers ◽

Baer M G Arts ◽

Alida A Postma ◽

Anna de Kort

Keyword(s):

Cerebral Amyloid Angiopathy ◽

Electroconvulsive Therapy ◽

Severe Depression ◽

Amyloid Angiopathy ◽

Amyloid Beta Protein ◽

Cerebral Blood Vessels ◽

Safety Measures ◽

Aβ Clearance ◽

Cerebral Amyloid ◽

The Impact

Cerebral amyloid angiopathy (CAA) is a condition characterised by accumulation of amyloid beta protein (Aβ) in the wall of cerebral blood vessels which increases the risk of intracranial haemorrhage and contributes to cognitive impairment. We describe the case of a man around the age of 70 with ‘probable’ CAA according to the modified Boston criteria and severe depression whose depression was treated successfully with electroconvulsive therapy (ECT). To the best of our knowledge, there are no earlier published reports of ECT in a patient with CAA. We briefly discuss possible safety measures for these patients, the impact of ECT on cognition in CAA and a possible influence of ECT on Aβ clearance.

Download Full-text

Breathing space: deoxygenation of aquatic environments can drive differential ecological impacts across biological invasion stages

Biological Invasions ◽

10.1007/s10530-021-02542-3 ◽

2021 ◽

Author(s):

James W. E. Dickey ◽

Neil E. Coughlan ◽

Jaimie T. A. Dick ◽

Vincent Médoc ◽

Monica McCard ◽

...

Keyword(s):

Climate Change ◽

Oxygen Saturation ◽

Ecological Impacts ◽

Neogobius Melanostomus ◽

Aquatic Environments ◽

Relative Impact ◽

Low Oxygen ◽

Per Capita ◽

The Impact ◽

Prey Populations

AbstractThe influence of climate change on the ecological impacts of invasive alien species (IAS) remains understudied, with deoxygenation of aquatic environments often-overlooked as a consequence of climate change. Here, we therefore assessed how oxygen saturation affects the ecological impact of a predatory invasive fish, the Ponto-Caspian round goby (Neogobius melanostomus), relative to a co-occurring endangered European native analogue, the bullhead (Cottus gobio) experiencing decline in the presence of the IAS. In individual trials and mesocosms, we assessed the effect of high, medium and low (90%, 60% and 30%) oxygen saturation on: (1) functional responses (FRs) of the IAS and native, i.e. per capita feeding rates; (2) the impact on prey populations exerted; and (3) how combined impacts of both fishes change over invasion stages (Pre-invasion, Arrival, Replacement, Proliferation). Both species showed Type II potentially destabilising FRs, but at low oxygen saturation, the invader had a significantly higher feeding rate than the native. Relative Impact Potential, combining fish per capita effects and population abundances, revealed that low oxygen saturation exacerbates the high relative impact of the invader. The Relative Total Impact Potential (RTIP), modelling both consumer species’ impacts on prey populations in a system, was consistently higher at low oxygen saturation and especially high during invader Proliferation. In the mesocosm experiment, low oxygen lowered RTIP where both species were present, but again the IAS retained high relative impact during Replacement and Proliferation stages at low oxygen. We also found evidence of multiple predator effects, principally antagonism. We highlight the threat posed to native communities by IAS alongside climate-related stressors, but note that solutions may be available to remedy hypoxia and potentially mitigate impacts across invasion stages.

Download Full-text

Preventive Effect of Liothyronine on Electroconvulsive Therapy-Induced Memory Deficit in Patients with Major Depressive Disorder: A Double-Blind Controlled Clinical Trial

BioMed Research International ◽

10.1155/2015/503918 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Arash Mohagheghi ◽

Asghar Arfaie ◽

Shahrokh Amiri ◽

Masoud Nouri ◽

Salman Abdi ◽

...

Keyword(s):

Clinical Trial ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Electroconvulsive Therapy ◽

Visual Memory ◽

Memory Deficit ◽

Control Group ◽

Major Depressive ◽

Double Blind ◽

The Impact

Introduction and Objective. Despite the effectiveness of electroconvulsive therapy (ECT) in treating major depressive disorder (MDD), its cognitive side effects make it less popular. This study investigated the impact of liothyronine on ECT-induced memory deficit in patients with MDD.Methodology. This is a double-blind clinical trial, in which 60 patients with MDD who were referred for ECT were selected. The diagnosis was based on the criteria of DSM-IV-TR. Patients were divided randomly into two groups to receive either liothyronine (50 mcg every morning) or placebo. After the assessment with Wechsler Memory Scale-Revised (WMS-R) before first session of ECT, posttests were repeated again, two months after the completion of ECT.Findings. By controlling the pretest scores, the mean scores of the experimental group were higher than the control group in delayed recall, verbal memory, visual memory, general memory, and attention/concentration scales (P<0.05).Conclusion. Liothyronine may prevent ECT-induced memory impairment in patients with MDD. This study has been registered in IRCT underIRCT201401122660N2.

Download Full-text

USE OF TELECOMMUNICATIONS TO REDUCE THE IMPACT OF THE COVID-19 PANDEMIC

UZBEK MEDICAL JOURNAL ◽

10.26739/2181-0664-2021-1-7 ◽

2021 ◽

Vol 2 (1) ◽

pp. 38-43

Author(s):

Abdullajon Komilov ◽

◽

Madinabonu Sultonova ◽

Durdona Orifjonova

Keyword(s):

Oxygen Saturation ◽

Chronic Diseases ◽

Direct Contact ◽

Healthcare Professionals ◽

Automatic Monitoring ◽

Saturation Level ◽

Blood Oxygen ◽

Blood Oxygen Saturation ◽

Oxygen Saturation Level ◽

The Impact

Today, the COVID-19 pandemic is one of the most pressing problems facing humanity. Therefore, reducing the population's level of infection with this virus is one of our government's main tasks.Therefore, it is necessary to isolate patients with chronic diseases as much as possible. Clients are more likely to be infected with caronavirus due to their age and the presence of underlying medical conditions.Limiting direct contact between such patients and observing healthcare professionals significantly reduces the patient's chances of contracting caronavirus.The article proposes a device design that allows for remote automatic monitoring of patients' condition being treated at home by an observing medical professional.With the proposed device's help, the patient's blood oxygen saturation level is automatically and remotely controlled. The device is built on an Arduino board.The use of the device greatly reduces the likelihood of contracting caronavirus in patients receiving home treatment.This could be one of the most important decisions in maintaining the health of the population today.

Download Full-text

Electroconvulsive Therapy and the Seizure Threshold*

The Canadian Journal of Psychiatry ◽

10.1177/070674378302800607 ◽

1983 ◽

Vol 28 (6) ◽

pp. 445-448 ◽

Cited By ~ 8

Author(s):

B.A. Martin ◽

S. Strigler ◽

K. Bezchlibnyk ◽

G.E. Harris-Brandts

Keyword(s):

Clinical Practice ◽

Electroconvulsive Therapy ◽

Electrical Energy ◽

Sine Wave ◽

Routine Clinical Practice ◽

Large Series ◽

Seizure Threshold ◽

Square Wave ◽

Rate Of Failure

The use of a pulsatile square wave stimulus for a large series of electroconvulsive treatments under conditions of routine clinical practice is compared to the equivalent experience with a sine wave stimulus. The literature indicates that both waveforms are equally effective convulsants. However, in this series, the induction of a convulsion was found to be much more difficult with the pulsatile square wave such that the rate of failure to convulse was four times that compared to sine wave stimulation. A number of variables that may affect the seizure threshold during ECT were examined. It is concluded that the benefit obtained by reducing the electrical energy transmitted to the patient with the pulsatile stimulus offsets the difficulty encountered in reaching the seizure threshold.

Download Full-text

Induction agents in electroconvulsive therapy: a comparison of methohexitone and propofol

Psychiatric Bulletin ◽

10.1192/pb.26.12.455 ◽

2002 ◽

Vol 26 (12) ◽

pp. 455-457 ◽

Cited By ~ 4

Author(s):

Allan Scott ◽

Harold Boddy

Keyword(s):

Electroconvulsive Therapy ◽

Therapeutic Efficacy ◽

Seizure Threshold ◽

Clinical Implications ◽

Seizure Duration ◽

Efficacy Of Treatment ◽

Induction Agents ◽

Subject Comparison

Aims and MethodTo compare methohexitone and propofol in electroconvulsive therapy (ECT). A retrospective within-subject comparison was made of the use of these drugs in separate courses of bilateral ECT in one clinic over 10 years. Patients taking mood stabilising or anti-epileptic drugs were excluded. The initial seizure threshold and seizure duration were of particular interest.ResultsThe median initial seizure thresholds were identical (75 mC). The median initial seizure duration with threshold stimulation was 25% shorter with propofol (21v.28 s). The median total numbers of treatments in the courses were identical (eight treatments).Clinical ImplicationsThe shorter seizure duration observed with propofol was not associated with a commensurate rise in the initial seizure threshold. The shorter seizure duration may therefore have no effect on the therapeutic efficacy of treatment.

Download Full-text