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Electro-convulsive therapy with minimum hazard

D Gordon

    The British Journal of Psychiatry : the Journal of Mental Science
    |July 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Inter-electrode resistance during electroconvulsive therapy (ECT) is highly variable, making shock measurement in joules unreliable. Current intensity, not energy, is a more effective measure for ECT seizure thresholds.

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    Area of Science:

    • Neuroscience
    • Medical Engineering
    • Clinical Practice

    Background:

    • Electroconvulsive therapy (ECT) is a medical procedure involving electrical stimulation of the brain.
    • Accurate measurement of electrical parameters during ECT is crucial for patient safety and treatment efficacy.
    • Previous methods for quantifying ECT energy may be compromised by variable patient resistance.

    Purpose of the Study:

    • To investigate the variability of inter-electrode resistance during ECT.
    • To determine the implications of this variability for measuring ECT shocks in joules.
    • To propose a more reliable method for assessing ECT stimulus intensity.

    Main Methods:

    • Utilized square wave electrical pulses during ECT.
    • Measured inter-electrode resistance across a range of patients.

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  • Recorded current intensity required to achieve seizure threshold.

    • Main Results:

    • Demonstrated significant variability in inter-electrode resistance during ECT.
    • Found that shock energy measured in joules is an invalid metric due to resistance fluctuations.
    • Identified a wide range of current thresholds (100 mA to >2,000 mA) for inducing convulsions.

    Conclusions:

    • Inter-electrode resistance variability invalidates joule-based ECT shock measurements.
    • Measuring current intensity with millisecond pulses and adequate intervals is recommended for ECT.
    • This approach offers a more precise and reliable method for assessing ECT stimulus parameters.