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Updated: Sep 10, 2025
Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
Intracranial electric field dosage and clinical response to electroconvulsive therapy in depressed patients
Chun-Lin Yang1, Han Wu1, Nian-Shuang Wu2
1The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China.
Background:
Electroconvulsive therapy (ECT) provides rapid relief of depressive symptoms. However, the relationship between intracranial electric field (E-field) distribution, dosage, and antidepressant outcomes remains underexplored.
Methods:
Thirty patients with depressive episodes received bifrontal ECT. Clinical symptoms were assessed using the 17-Item Hamilton Rating Scale for Depression at baseline and post-ECT treatment. Magnetic resonance imaging was performed at baseline to calculate E-field strength and intracranial E-field dosage.
Results:
No significant associations were found between accumulated or average E-field dosage and overall antidepressant outcomes. However, significant associations were observed between antidepressant outcomes and E-field dosage during the initial ECT session in key brain regions, including the amygdala, anterior cingulate cortex, cerebellum, hippocampus, medial para-hippocampal cortex, postcentral gyrus, thalamus, and superior frontal lobe (P all < 0.05).
Conclusions:
While no significant associations were found between cumulative or average E-field dosage and antidepressant outcomes of ECT, significant associations were observed between E-field dosage in key brain regions and antidepressant outcomes during the initial ECT session. These findings suggest that individualized ECT protocols, tailored to patient-specific neuroanatomy and E-field dosage in specific brain regions, may enhance ECT's therapeutic efficacy. Future research should explore personalized ECT protocols using computer-modeled E-field distribution and ECT parameters.
