Computational comparison of conventional and novel electroconvulsive therapy electrode placements for the treatment of depression

Publication date: August 2019Source: European Psychiatry, Volume 60Author(s): Siwei Bai, Donel Martin, Tianruo Guo, Socrates Dokos, Colleen LooAbstractBackgroundElectroconvulsive therapy (ECT) is a highly effective treatment for severe psychiatric disorders. Despite its high efficacy, the use of ECT would be greater if the risk of cognitive side effects were reduced. Over the last 20 years, developments in ECT technique, including improvements in the dosing methodology and modification of the stimulus waveform, have allowed for improved treatment methods with reduced adverse cognitive effects. There is increasing evidence that the electrode placement is important for orienting the electrical stimulus and therefore modifying treatment outcomes, with potential for further improvement of the placements currently used in ECT.ObjectiveWe used computational modelling to perform an in-depth examination into regional differences in brain excitation by the ECT stimulus for several lesser known and novel electrode placements, in order to investigate the potential for an electrode placement that may optimise clinical outcomes.MethodsHigh resolution finite element human head models were generated from MRI scans of three subjects. The models were used to compare regional differences in average electric field (EF) magnitude among a total of thirteen bipolar ECT electrode placements, i.e. three conventional placements as well as ten lesser known and novel placements.Results and conclusionIn...
Source: European Psychiatry - Category: Psychiatry Source Type: research