EEG effects of ECT: implications for rTMS.

Published

Journal Article (Review)

Electroconvulsive therapy (ECT) involves the use of electrical stimulation to elicit a series of generalized tonic-clonic seizures for therapeutic purposes and is the most effective treatment known for major depression. These treatments have significant neurophysiologic effects, many of which are manifest in the electroencephalogram (EEG). The relationship between EEG data and the response to ECT has been studied since the 1940s, but for many years no consistent correlates were found. Recent studies indicate that a number of specific EEG features recorded during the induced seizures (ictal EEG) as well as before and after a course of treatment (interictal EEG) are related to both the therapeutic efficacy and cognitive side effects. Similar to ECT, repetitive transcranial magnetic stimulation (rTMS), which involves focal electromagnetic stimulation of cortical neurons, has also been studied as an antidepressant therapy and also appears to have neurophysiologic effects, although these have not been as fully investigated as is the case with ECT. Given the similarity of these treatments, it is natural to consider whether advances in understanding the electrophysiologic correlates of the ECT response might have implications for rTMS. The present article reviews the literature on the EEG effects of ECT and discusses the implications in terms of the likely efficacy and side effects associated with rTMS in specific anatomic locations, the potential for producing an antidepressant response with rTMS without eliciting seizure activity, eliciting focal seizures with rTMS, and the possibility of using rTMS to focally modulate seizure induction and spread with ECT to optimize treatment.

Full Text

Duke Authors

Cited Authors

  • Krystal, AD; West, M; Prado, R; Greenside, H; Zoldi, S; Weiner, RD

Published Date

  • 2000

Published In

Volume / Issue

  • 12 / 3

Start / End Page

  • 157 - 165

PubMed ID

  • 11126190

Pubmed Central ID

  • 11126190

International Standard Serial Number (ISSN)

  • 1091-4269

Digital Object Identifier (DOI)

  • 10.1002/1520-6394(2000)12:3<157::AID-DA7>3.0.CO;2-R

Language

  • eng

Conference Location

  • United States