TY - JOUR
T1 - Electric Field, Ictal Theta Power, and Clinical Outcomes in Electroconvulsive Therapy
AU - Miller, Jeremy
AU - Jones, Tom
AU - Upston, Joel
AU - Deng, Zhi De
AU - McClintock, Shawn M.
AU - Erhardt, Erik
AU - Farrar, Danielle
AU - Abbott, Christopher C.
N1 - Funding Information:
This study was supported by the National Institute of General Medical Sciences of the National Institutes of Health (Grant No. P30GM122734 [to CCA] and Grant No. S10OD025313 [to CCA]) ; Office of the Director , National Institutes of Health (Grant No. MH125126 [to JM]) ; and the National Institute of Mental Health Intramural Research Program (Grant No. ZIAMH002955 [to Z-DD]). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2023 Society of Biological Psychiatry
PY - 2023/7
Y1 - 2023/7
N2 - Background: Electroconvulsive therapy (ECT) is efficacious for treatment-resistant depression. Treatment-induced cognitive impairment can adversely impact functional outcomes. Our pilot study linked the electric field to ictal theta power from a single suprathreshold treatment and linked ictal theta power to changes in phonemic fluency. In this study, we set out to replicate our findings and expand upon the utility of ictal theta power as a potential cognitive biomarker. Methods: Twenty-seven participants (18 female and 9 male) received right unilateral ECT for treatment-resistant depression. Pre-ECT magnetic resonance imaging and finite element modeling determined the 90th percentile maximum electric field in the brain. Two-lead electroencephalographs were digitally captured across the ECT course, with the earliest suprathreshold treatment used to determine power spectral density. Clinical and cognitive outcomes were assessed pre-, mid-, and post-ECT. We assessed the relationship between the electric field in the brain, ictal theta power, clinical outcome (Inventory of Depressive Symptomatology), and cognitive outcomes (phonemic and semantic fluency) with linear models. Results: Ictal theta power in the Fp1 and Fp2 channels was associated with the electric field, antidepressant outcome, and phonemic and semantic fluency. The relationship between ictal theta power and phonemic fluency was strengthened in the longitudinal analysis. The electric field in the brain was directly associated with phonemic and semantic fluency but not with antidepressant outcome. Conclusions: Ictal theta power is a potential cognitive biomarker early on in the ECT course to help guide parameter changes. Larger studies are needed to further assess ictal theta power's role in predicting mood outcome and changes with ECT parameters.
AB - Background: Electroconvulsive therapy (ECT) is efficacious for treatment-resistant depression. Treatment-induced cognitive impairment can adversely impact functional outcomes. Our pilot study linked the electric field to ictal theta power from a single suprathreshold treatment and linked ictal theta power to changes in phonemic fluency. In this study, we set out to replicate our findings and expand upon the utility of ictal theta power as a potential cognitive biomarker. Methods: Twenty-seven participants (18 female and 9 male) received right unilateral ECT for treatment-resistant depression. Pre-ECT magnetic resonance imaging and finite element modeling determined the 90th percentile maximum electric field in the brain. Two-lead electroencephalographs were digitally captured across the ECT course, with the earliest suprathreshold treatment used to determine power spectral density. Clinical and cognitive outcomes were assessed pre-, mid-, and post-ECT. We assessed the relationship between the electric field in the brain, ictal theta power, clinical outcome (Inventory of Depressive Symptomatology), and cognitive outcomes (phonemic and semantic fluency) with linear models. Results: Ictal theta power in the Fp1 and Fp2 channels was associated with the electric field, antidepressant outcome, and phonemic and semantic fluency. The relationship between ictal theta power and phonemic fluency was strengthened in the longitudinal analysis. The electric field in the brain was directly associated with phonemic and semantic fluency but not with antidepressant outcome. Conclusions: Ictal theta power is a potential cognitive biomarker early on in the ECT course to help guide parameter changes. Larger studies are needed to further assess ictal theta power's role in predicting mood outcome and changes with ECT parameters.
KW - Biomarker
KW - Clinical outcomes
KW - Electric field
KW - Electroconvulsive therapy
KW - Ictal theta power
KW - Phonemic fluency
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U2 - 10.1016/j.bpsc.2023.03.001
DO - 10.1016/j.bpsc.2023.03.001
M3 - Article
C2 - 36925066
AN - SCOPUS:85153945941
SN - 2451-9022
VL - 8
SP - 760
EP - 767
JO - Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
JF - Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
IS - 7
ER -