Postictal generalized electroencephalographic suppression following electroconvulsive therapy: Temporal characteristics and impact of anesthetic regimen.

Autor: Hickman LB; Department of Internal Medicine, University of California, Irvine School of Medicine, Orange, CA, USA; Department of Internal Medicine, University of California, Irvine School of Medicine, Orange, CA, USA., Kafashan M; Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA., Labonte AK; Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA., Chan CW; Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA., Huels ER; Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA; Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA., Guay CS; Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA., Guan MJ; Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Kansas City University of Medicine and Biosciences, Kansas City, MO, USA., Ching S; Department of Electrical & Systems Engineering, Washington University in St. Louis, St. Louis, MO, USA; Division of Biology and Biomedical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA., Lenze EJ; Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA., Farber NB; Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA., Avidan MS; Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA., Hogan RE; Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA., Palanca BJA; Department of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Division of Biology and Biomedical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA; Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA. Electronic address: palancab@wustl.edu.
Jazyk: angličtina
Zdroj: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2021 Apr; Vol. 132 (4), pp. 977-983. Date of Electronic Publication: 2021 Jan 28.
DOI: 10.1016/j.clinph.2020.12.018
Abstrakt: Objective: Postictal generalized electroencephalographic suppression (PGES) has been defined as electroencephalographic (EEG) activity of less than 10 microvolts following a generalized seizure. PGES is associated with an increased risk of sudden unexplained death in epilepsy, as well as treatment efficacy of electroconvulsive therapy (ECT). We investigated the impact of anesthetic on PGES expression and temporal characteristics.
Methods: We recorded postictal EEG in 50 ECT sessions in 11 patients with treatment resistant depression (ClinicalTrials.gov NCT02761330). For each participant, repeated sessions included either ketamine or etomidate general anesthesia during ECT. An automated algorithm was employed to detect PGES within 5 minutes after seizure termination.
Results: PGES was detected in 31/50 recordings, with intermittent epochs recurring up to five minutes after seizure termination. PGES total duration was greater following ketamine than etomidate anesthesia (p = 0.04). PGES expression declined loglinearly as a function of time (r = -0.89, p < 10 -4 ). EEG amplitude during PGES did not vary linearly with time.
Conclusions: PGES can occur intermittently for several minutes following seizure termination. Anesthetic effects should be considered when correlating PGES duration to clinical outcomes.
Significance: Prolonged EEG monitoring several minutes following seizure termination may be necessary to fully evaluate the presence and total duration of PGES.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2021 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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