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Acute cognitive effects of subconvulsive electrical stimulation
J Prudic1, H A Sackeim, D P Devanand
1Department of Biological Psychiatry, New York State Psychiatric Institute, New York 10032.
Convulsive Therapy
|March 1, 1994
Summary
Subconvulsive electrical stimulation, used to estimate seizure threshold in electroconvulsive therapy (ECT), did not cause adverse cognitive effects. Patients receiving right unilateral or bilateral ECT showed no negative impacts on cognition from this stimulation method.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Neurophysiology
Background:
- Empirical titration procedures using subconvulsive electrical stimulation are increasingly used to estimate seizure threshold.
- The impact of subconvulsive stimulation on acute cognitive outcomes following electroconvulsive therapy (ECT) remains unevaluated.
Purpose of the Study:
- To evaluate the acute cognitive consequences of subconvulsive electrical stimulation preceding electroconvulsive therapy (ECT).
Main Methods:
- Two studies randomized depressed patients to right unilateral or bilateral ECT.
- Stimulus intensity was maintained just above seizure threshold.
- Neuropsychological evaluations were conducted, contrasting sessions with subconvulsive stimulation preceding a seizure versus those with a single convulsive stimulation.
Main Results:
- Approximately 40% of treatment sessions involved one or more subconvulsive stimuli preceding a generalized seizure.
- No adverse cognitive consequences were observed across various neuropsychological measures associated with subconvulsive stimulation.
Conclusions:
- Subconvulsive electrical stimulation, when used in empirical titration for ECT, does not appear to produce acute adverse cognitive effects.
- This finding supports the safety of using empirical titration methods in ECT administration.