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Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
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Predicting postictal suppression in electroconvulsive therapy using analysis of heart rate variability.
Takafumi Watanabe1, Miho Miyajima2, Katsuya Ohta3
1Tokyo Metropolitan Health and Medical Corporation Toshima Hospital, Tokyo, Japan; Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Narimasu Kosei Hospital, Tokyo, Japan.
Journal of Affective Disorders
|January 1, 2019
Summary
Heart rate variability (HRV) before electroconvulsive therapy (ECT) can predict postictal suppression on electroencephalogram (EEG). Higher parasympathetic activity (HF) is linked to better seizure suppression, aiding treatment efficacy prediction.
Area of Science:
- Neuroscience
- Psychiatry
- Cardiology
Background:
- Postictal suppression on electroencephalogram (EEG) during electroconvulsive therapy (ECT) is a key indicator of treatment efficacy.
- Predicting postictal suppression is crucial for optimizing ECT outcomes.
- Heart rate variability (HRV) offers a non-invasive measure of autonomic nervous system activity.
Purpose of the Study:
- To investigate the potential of pre-treatment heart rate variability (HRV) as a predictor of postictal suppression on EEG during electroconvulsive therapy (ECT).
- To explore the association between specific HRV indices, reflecting autonomic nervous system activity, and the occurrence and characteristics of postictal suppression.
Main Methods:
- Analysis of resting HRV in the frequency domain, focusing on high-frequency (HF) component (parasympathetic activity) and low-frequency/high-frequency (LF/HF) ratio (sympathetic activity), in 21 patients with depression undergoing bilateral pulse wave ECT.
- Natural log transformation of HRV indices (ln[HF], ln[LF/HF]) for statistical analysis.
- Evaluation of ictal and peri-ictal EEG parameters and their correlation with HRV indices.
Main Results:
- A significant positive association was found between postictal suppression and ln[HF], indicating that higher parasympathetic activity before ECT predicts greater postictal suppression.
- Postictal suppression remained a significant predictor of ln[HF] even after adjusting for patient age in a multiple regression model.
- Postictal regularity also showed a positive association with ln[HF].
Conclusions:
- Pre-treatment ln[HF], a measure of parasympathetic activity, can serve as a valuable predictor of postictal suppression on EEG during ECT.
- These findings suggest that HRV assessment before ECT may help identify patients likely to achieve significant postictal suppression, potentially guiding treatment strategies.
- Further research is warranted to explore the influence of factors like comorbidities and ECT polarity on this relationship.
Keywords:
DepressionElectroconvulsive therapyHeart rate variabilityParasympathetic activityPostictal suppressionMore Related Videos
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