Bispectral EEG (BSEEG) to assess arousal after electro-convulsive therapy (ECT)

Area of Science:

• Neuroscience
• Clinical Neurophysiology

Background:

• Postictal confusion is a common complication after electro-convulsive therapy (ECT).
• Current methods for assessing postictal confusion lack quantitative precision.
• There is a need for objective tools to monitor cognitive status after ECT.

Purpose of the Study:

• To evaluate a point-of-care, two-channel frontal electroencephalography (EEG) device for quantitative measurement of postictal confusion.
• To assess the utility of a bispectral EEG (BSEEG) score in monitoring patients immediately following ECT.
• To determine if BSEEG can provide a continuous, clinical measure of the postictal state.

Main Methods:

• Fifty patients undergoing ECT were enrolled.
• Frontal bispectral EEG (BSEEG) recordings were obtained at baseline and 10-20 minutes post-ECT using a hand-held device.
• Power spectral density analysis was used to calculate the BSEEG score and compare pre- and post-ECT states.

Main Results:

• The BSEEG score significantly indicated postictal confusion compared to baseline.
• In a subset of 5 patients, continuous EEG monitoring showed BSEEG scores returned to baseline within 2-3 hours post-ECT.
• The BSEEG score demonstrated a clear distinction between pre-ECT baseline and post-ECT confusion.

Conclusions:

• The BSEEG score effectively distinguishes baseline neurological states from postictal confusion after ECT.
• This quantitative EEG measure can assess the duration of recovery from postictal confusion.
• BSEEG offers a potentially more sensitive method for monitoring patient arousal post-ECT compared to subjective assessments.