The effects of ECT stimulus dose and electrode placement on the Ictal electroencephalogram: An intraindividual crossover study
Recent evidence suggests that electroconvulsive therapy (ECT) efficacy depends upon both electrode placement and the degree to which stimulus dosage exceeds seizure threshold (T), and not simply on surpassing a minimum seizure duration as has been assumed. In light of these findings and studies repo...
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| Veröffentlicht in: | Biological psychiatry (1969) 1993-12, Vol.34 (11), p.759-767 |
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| container_end_page | 767 |
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| container_issue | 11 |
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| container_title | Biological psychiatry (1969) |
| container_volume | 34 |
| creator | Krystal, Andrew D. Weiner, Richard D. McCall, W.Vaughn Shelp, Frank E. Arias, Rebecca Smith, Pamela |
| description | Recent evidence suggests that electroconvulsive therapy (ECT) efficacy depends upon both electrode placement and the degree to which stimulus dosage exceeds seizure threshold (T), and not simply on surpassing a minimum seizure duration as has been assumed. In light of these findings and studies reporting ictal electroencephalogram (EEG) differences between bilateral and unilateral ECT, we performed this 19-subject intraindividual crossover study of the effects of dose and electrode placement on the ictal EEG.
We found ictal EEG evidence of greater seizure intensity with bilateral than unilateral ECT and with higher dosage (2.25 T) compared with barely suprathreshold stimuli. Seizure duration was no longer with bilateral than unilateral ECT and actually decreased with increased dose. A number of ictal EEG variables separated the unilateral 2.25 T and unilateral T conditions, which reportedly differ in efficacy, and therefore, these EEG measures show promise as markers of treatment adequacy. |
| doi_str_mv | 10.1016/0006-3223(93)90064-K |
| format | Article |
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We found ictal EEG evidence of greater seizure intensity with bilateral than unilateral ECT and with higher dosage (2.25 T) compared with barely suprathreshold stimuli. Seizure duration was no longer with bilateral than unilateral ECT and actually decreased with increased dose. A number of ictal EEG variables separated the unilateral 2.25 T and unilateral T conditions, which reportedly differ in efficacy, and therefore, these EEG measures show promise as markers of treatment adequacy.</description><identifier>ISSN: 0006-3223</identifier><identifier>EISSN: 1873-2402</identifier><identifier>DOI: 10.1016/0006-3223(93)90064-K</identifier><identifier>PMID: 8292679</identifier><identifier>CODEN: BIPCBF</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Analysis of Variance ; Biological and medical sciences ; Brain - physiopathology ; Depressive Disorder - therapy ; ECT ; EEG ; Electroconvulsive therapy ; Electroconvulsive Therapy - instrumentation ; electrode placement ; Electrodes ; Electroencephalography ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; seizure adequacy ; stimulus dose ; Treatments</subject><ispartof>Biological psychiatry (1969), 1993-12, Vol.34 (11), p.759-767</ispartof><rights>1993</rights><rights>1994 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-bd99f9fc2e1478e44aac19ce26c9782f416dcf168ae292cce8f015cecbb3d9fd3</citedby><cites>FETCH-LOGICAL-c386t-bd99f9fc2e1478e44aac19ce26c9782f416dcf168ae292cce8f015cecbb3d9fd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0006-3223(93)90064-K$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3836614$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8292679$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Krystal, Andrew D.</creatorcontrib><creatorcontrib>Weiner, Richard D.</creatorcontrib><creatorcontrib>McCall, W.Vaughn</creatorcontrib><creatorcontrib>Shelp, Frank E.</creatorcontrib><creatorcontrib>Arias, Rebecca</creatorcontrib><creatorcontrib>Smith, Pamela</creatorcontrib><title>The effects of ECT stimulus dose and electrode placement on the Ictal electroencephalogram: An intraindividual crossover study</title><title>Biological psychiatry (1969)</title><addtitle>Biol Psychiatry</addtitle><description>Recent evidence suggests that electroconvulsive therapy (ECT) efficacy depends upon both electrode placement and the degree to which stimulus dosage exceeds seizure threshold (T), and not simply on surpassing a minimum seizure duration as has been assumed. In light of these findings and studies reporting ictal electroencephalogram (EEG) differences between bilateral and unilateral ECT, we performed this 19-subject intraindividual crossover study of the effects of dose and electrode placement on the ictal EEG.
We found ictal EEG evidence of greater seizure intensity with bilateral than unilateral ECT and with higher dosage (2.25 T) compared with barely suprathreshold stimuli. Seizure duration was no longer with bilateral than unilateral ECT and actually decreased with increased dose. A number of ictal EEG variables separated the unilateral 2.25 T and unilateral T conditions, which reportedly differ in efficacy, and therefore, these EEG measures show promise as markers of treatment adequacy.</description><subject>Adult</subject><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Brain - physiopathology</subject><subject>Depressive Disorder - therapy</subject><subject>ECT</subject><subject>EEG</subject><subject>Electroconvulsive therapy</subject><subject>Electroconvulsive Therapy - instrumentation</subject><subject>electrode placement</subject><subject>Electrodes</subject><subject>Electroencephalography</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>seizure adequacy</subject><subject>stimulus dose</subject><subject>Treatments</subject><issn>0006-3223</issn><issn>1873-2402</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1993</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMGKFDEQhoMo67j6Bgo5iOihtZP0pDsehGVYddkFL-M5ZCoVN5JOxqR7YC8-u2lnnKMQCMX_VaXyEfKSte9Zy-SHtm1lIzgXb5V4p2rRNbePyIoNvWh41_LHZHVGnpJnpfysZc85uyAXA1dc9mpFfm_vkaJzCFOhydHrzZaWyY9zmAu1qSA10VIMNc_JIt0HAzhinGiKdKq9NzCZ8A_ACLi_NyH9yGb8SK8i9XHKxkfrD97OFYScSkkHzPWV2T48J0-cCQVfnO5L8v3z9Xbztbn79uVmc3XXgBjk1OysUk454Mi6fsCuMwaYAuQSVD9w1zFpwTE5GKwfA8DBtWwNCLudsMpZcUneHOfuc_o1Y5n06AtgCCZimovuJZOKrdcV7I7g30UzOr3PfjT5QbNWL9r14lQvTrWqZ9Gub2vbq9P8eTeiPTedPNf89Sk3BUxw2UTw5YyJQUjJuop9OmJYXRw8Zl3AL1Ktz1Wwtsn_f48_jWChdw</recordid><startdate>19931201</startdate><enddate>19931201</enddate><creator>Krystal, Andrew D.</creator><creator>Weiner, Richard D.</creator><creator>McCall, W.Vaughn</creator><creator>Shelp, Frank E.</creator><creator>Arias, Rebecca</creator><creator>Smith, Pamela</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19931201</creationdate><title>The effects of ECT stimulus dose and electrode placement on the Ictal electroencephalogram: An intraindividual crossover study</title><author>Krystal, Andrew D. ; Weiner, Richard D. ; McCall, W.Vaughn ; Shelp, Frank E. ; Arias, Rebecca ; Smith, Pamela</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-bd99f9fc2e1478e44aac19ce26c9782f416dcf168ae292cce8f015cecbb3d9fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1993</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Brain - physiopathology</topic><topic>Depressive Disorder - therapy</topic><topic>ECT</topic><topic>EEG</topic><topic>Electroconvulsive therapy</topic><topic>Electroconvulsive Therapy - instrumentation</topic><topic>electrode placement</topic><topic>Electrodes</topic><topic>Electroencephalography</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>seizure adequacy</topic><topic>stimulus dose</topic><topic>Treatments</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Krystal, Andrew D.</creatorcontrib><creatorcontrib>Weiner, Richard D.</creatorcontrib><creatorcontrib>McCall, W.Vaughn</creatorcontrib><creatorcontrib>Shelp, Frank E.</creatorcontrib><creatorcontrib>Arias, Rebecca</creatorcontrib><creatorcontrib>Smith, Pamela</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Biological psychiatry (1969)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krystal, Andrew D.</au><au>Weiner, Richard D.</au><au>McCall, W.Vaughn</au><au>Shelp, Frank E.</au><au>Arias, Rebecca</au><au>Smith, Pamela</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effects of ECT stimulus dose and electrode placement on the Ictal electroencephalogram: An intraindividual crossover study</atitle><jtitle>Biological psychiatry (1969)</jtitle><addtitle>Biol Psychiatry</addtitle><date>1993-12-01</date><risdate>1993</risdate><volume>34</volume><issue>11</issue><spage>759</spage><epage>767</epage><pages>759-767</pages><issn>0006-3223</issn><eissn>1873-2402</eissn><coden>BIPCBF</coden><abstract>Recent evidence suggests that electroconvulsive therapy (ECT) efficacy depends upon both electrode placement and the degree to which stimulus dosage exceeds seizure threshold (T), and not simply on surpassing a minimum seizure duration as has been assumed. In light of these findings and studies reporting ictal electroencephalogram (EEG) differences between bilateral and unilateral ECT, we performed this 19-subject intraindividual crossover study of the effects of dose and electrode placement on the ictal EEG.
We found ictal EEG evidence of greater seizure intensity with bilateral than unilateral ECT and with higher dosage (2.25 T) compared with barely suprathreshold stimuli. Seizure duration was no longer with bilateral than unilateral ECT and actually decreased with increased dose. A number of ictal EEG variables separated the unilateral 2.25 T and unilateral T conditions, which reportedly differ in efficacy, and therefore, these EEG measures show promise as markers of treatment adequacy.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>8292679</pmid><doi>10.1016/0006-3223(93)90064-K</doi><tpages>9</tpages></addata></record> |
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| subjects | Adult Aged Analysis of Variance Biological and medical sciences Brain - physiopathology Depressive Disorder - therapy ECT EEG Electroconvulsive therapy Electroconvulsive Therapy - instrumentation electrode placement Electrodes Electroencephalography Female Humans Male Medical sciences Middle Aged Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry seizure adequacy stimulus dose Treatments |
| title | The effects of ECT stimulus dose and electrode placement on the Ictal electroencephalogram: An intraindividual crossover study |
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