Electric Field, Ictal Theta Power, and Clinical Outcomes in Electroconvulsive Therapy.

Autor: Miller J; Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico. Electronic address: jermiller@salud.unm.edu., Jones T; Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico., Upston J; Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico., Deng ZD; Computational Neurostimulation Research Program, Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina., McClintock SM; Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas., Erhardt E; Department of Mathematics and Statistics, University of New Mexico, Albuquerque, New Mexico., Farrar D; Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico., Abbott CC; Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico. Electronic address: cabbott@salud.unm.edu.
Jazyk: angličtina
Zdroj: Biological psychiatry. Cognitive neuroscience and neuroimaging [Biol Psychiatry Cogn Neurosci Neuroimaging] 2023 Jul; Vol. 8 (7), pp. 760-767. Date of Electronic Publication: 2023 Mar 15.
DOI: 10.1016/j.bpsc.2023.03.001
Abstrakt: Background: Electroconvulsive therapy (ECT) is efficacious for treatment-resistant depression. Treatment-induced cognitive impairment can adversely impact functional outcomes. Our pilot study linked the electric field to ictal theta power from a single suprathreshold treatment and linked ictal theta power to changes in phonemic fluency. In this study, we set out to replicate our findings and expand upon the utility of ictal theta power as a potential cognitive biomarker.
Methods: Twenty-seven participants (18 female and 9 male) received right unilateral ECT for treatment-resistant depression. Pre-ECT magnetic resonance imaging and finite element modeling determined the 90th percentile maximum electric field in the brain. Two-lead electroencephalographs were digitally captured across the ECT course, with the earliest suprathreshold treatment used to determine power spectral density. Clinical and cognitive outcomes were assessed pre-, mid-, and post-ECT. We assessed the relationship between the electric field in the brain, ictal theta power, clinical outcome (Inventory of Depressive Symptomatology), and cognitive outcomes (phonemic and semantic fluency) with linear models.
Results: Ictal theta power in the Fp1 and Fp2 channels was associated with the electric field, antidepressant outcome, and phonemic and semantic fluency. The relationship between ictal theta power and phonemic fluency was strengthened in the longitudinal analysis. The electric field in the brain was directly associated with phonemic and semantic fluency but not with antidepressant outcome.
Conclusions: Ictal theta power is a potential cognitive biomarker early on in the ECT course to help guide parameter changes. Larger studies are needed to further assess ictal theta power's role in predicting mood outcome and changes with ECT parameters.
(Copyright © 2023 Society of Biological Psychiatry. All rights reserved.)
Databáze: MEDLINE
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