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04:51
Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
Change in seizure threshold during electroconvulsive therapy.
Max Fink1, Georgios Petrides, Charles Kellner
1Long Island Jewish-Hillside Hospital, Glen Oaks, NY, USA. mafink@attglobal.net
The Journal of ECT
|June 27, 2008
Summary
The seizure threshold (ST) in electroconvulsive therapy (ECT) did not consistently increase with remission in unipolar depressed patients. This study examined ST changes after successful ECT treatment.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Medicine
Background:
- The seizure threshold (ST) quantifies the minimum electrical energy for inducing a grand mal seizure.
- Dose titration of ST is a proposed method to optimize electroconvulsive therapy (ECT) stimulus dosing.
- Understanding ST changes during remission is crucial for refining ECT protocols.
Purpose of the Study:
- To investigate the relationship between seizure threshold and remission in unipolar depression patients undergoing ECT.
- To determine if the seizure threshold consistently changes as patients achieve remission from depression.
Main Methods:
- A cohort of unipolar depressed patients receiving continuation treatment after successful ECT was studied.
- Seizure threshold (ST) was measured at the initial ECT treatment and one week post-remission.
- Bilateral electrode placement was used, with stimulation at 150% above the measured ST.
Main Results:
- In 80 subjects, the seizure threshold remained stable in 70% of patients at remission.
- A notable increase in ST was observed in 21% of patients.
- A decrease in ST was recorded in 9% of the study participants.
Conclusions:
- The seizure threshold does not conclusively rise with remission in patients receiving bilateral ECT.
- Findings suggest variability in ST response to remission, impacting ECT dose optimization strategies.
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