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Minimum Electric Field Exposure for Seizure Induction with Electroconvulsive Therapy and Magnetic Seizure Therapy.

Publication ,  Journal Article
Lee, WH; Lisanby, SH; Laine, AF; Peterchev, AV
Published in: Neuropsychopharmacology
May 2017

Lowering and individualizing the current amplitude in electroconvulsive therapy (ECT) has been proposed as a means to produce stimulation closer to the neural activation threshold and more focal seizure induction, which could potentially reduce cognitive side effects. However, the effect of current amplitude on the electric field (E-field) in the brain has not been previously linked to the current amplitude threshold for seizure induction. We coupled MRI-based E-field models with amplitude titrations of motor threshold (MT) and seizure threshold (ST) in four nonhuman primates (NHPs) to determine the strength, distribution, and focality of stimulation in the brain for four ECT electrode configurations (bilateral, bifrontal, right-unilateral, and frontomedial) and magnetic seizure therapy (MST) with cap coil on vertex. At the amplitude-titrated ST, the stimulated brain subvolume (23-63%) was significantly less than for conventional ECT with high, fixed current (94-99%). The focality of amplitude-titrated right-unilateral ECT (25%) was comparable to cap coil MST (23%), demonstrating that ECT with a low current amplitude and focal electrode placement can induce seizures with E-field as focal as MST, although these electrode and coil configurations affect differently specific brain regions. Individualizing the current amplitude reduced interindividual variation in the stimulation focality by 40-53% for ECT and 26% for MST, supporting amplitude individualization as a means of dosing especially for ECT. There was an overall significant correlation between the measured amplitude-titrated ST and the prediction of the E-field models, supporting a potential role of these models in dosing of ECT and MST. These findings may guide the development of seizure therapy dosing paradigms with improved risk/benefit ratio.

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Published In

Neuropsychopharmacology

DOI

EISSN

1740-634X

Publication Date

May 2017

Volume

42

Issue

6

Start / End Page

1192 / 1200

Location

England

Related Subject Headings

  • Psychiatry
  • Male
  • Magnetic Resonance Imaging
  • Magnetic Field Therapy
  • Macaca mulatta
  • Electroconvulsive Therapy
  • Brain
  • Animals
  • 5202 Biological psychology
  • 3209 Neurosciences
 

Citation

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Lee, W. H., Lisanby, S. H., Laine, A. F., & Peterchev, A. V. (2017). Minimum Electric Field Exposure for Seizure Induction with Electroconvulsive Therapy and Magnetic Seizure Therapy. Neuropsychopharmacology, 42(6), 1192–1200. https://doi.org/10.1038/npp.2016.276
Lee, Won H., Sarah H. Lisanby, Andrew F. Laine, and Angel V. Peterchev. “Minimum Electric Field Exposure for Seizure Induction with Electroconvulsive Therapy and Magnetic Seizure Therapy.Neuropsychopharmacology 42, no. 6 (May 2017): 1192–1200. https://doi.org/10.1038/npp.2016.276.
Lee WH, Lisanby SH, Laine AF, Peterchev AV. Minimum Electric Field Exposure for Seizure Induction with Electroconvulsive Therapy and Magnetic Seizure Therapy. Neuropsychopharmacology. 2017 May;42(6):1192–200.
Lee, Won H., et al. “Minimum Electric Field Exposure for Seizure Induction with Electroconvulsive Therapy and Magnetic Seizure Therapy.Neuropsychopharmacology, vol. 42, no. 6, May 2017, pp. 1192–200. Pubmed, doi:10.1038/npp.2016.276.
Lee WH, Lisanby SH, Laine AF, Peterchev AV. Minimum Electric Field Exposure for Seizure Induction with Electroconvulsive Therapy and Magnetic Seizure Therapy. Neuropsychopharmacology. 2017 May;42(6):1192–1200.

Published In

Neuropsychopharmacology

DOI

EISSN

1740-634X

Publication Date

May 2017

Volume

42

Issue

6

Start / End Page

1192 / 1200

Location

England

Related Subject Headings

  • Psychiatry
  • Male
  • Magnetic Resonance Imaging
  • Magnetic Field Therapy
  • Macaca mulatta
  • Electroconvulsive Therapy
  • Brain
  • Animals
  • 5202 Biological psychology
  • 3209 Neurosciences