Effects of modifying the electrode placement and pulse width on cognitive side effects with unilateral ECT: A pilot randomised controlled study with computational modelling

Background: The electrode placement and pulse width for electroconvulsive therapy (ECT) are important treatment parameters associated with ECT related retrograde memory side-effects. Modification of these parameters with right unilateral (RUL) ECT may have utility for further reducing these side-eff...

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Autores principales:	Donel M. Martin, Azam Ahmad Bakir, Feng Lin, Rohan Francis-Taylor, Abdulrahman Alduraywish, Siwei Bai, Dusan Hadzi-Pavlovic, Socrates Dokos, Colleen K. Loo
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Electroconvulsive therapy Right unilateral Pulse width Memory Computational modelling Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/3c8469597a384a33a86d53a6dc94a962
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spelling	oai:doaj.org-article:3c8469597a384a33a86d53a6dc94a9622021-11-20T04:58:33ZEffects of modifying the electrode placement and pulse width on cognitive side effects with unilateral ECT: A pilot randomised controlled study with computational modelling1935-861X10.1016/j.brs.2021.09.014https://doaj.org/article/3c8469597a384a33a86d53a6dc94a9622021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1935861X21002461https://doaj.org/toc/1935-861XBackground: The electrode placement and pulse width for electroconvulsive therapy (ECT) are important treatment parameters associated with ECT related retrograde memory side-effects. Modification of these parameters with right unilateral (RUL) ECT may have utility for further reducing these side-effects. Objective: This study explored use of the frontoparietal (FP) placement for reducing retrograde memory side effects with ECT. We hypothesised that superior retrograde memory outcomes would occur with FP compared to temporoparietal (TP) placement and with ultrabrief (UB: 0.3 ms) compared to brief pulse (BP: 1.0 ms) width ECT. Methods: In this randomised cross-over, double-blinded study, participants received a single treatment of BP TP, BP FP, UB TP and UB FP ECT. Neuropsychological testing was conducted prior to and immediately following each treatment. Computational modelling was conducted to explore associations between E-fields in regions-of-interest associated with memory. Results: Nine participants completed the study. The FP placement was not superior to TP for retrograde memory outcomes. For both electrode placements UB pulse width was associated with significantly better visual retrograde memory compared to BP (p < .05). With TP ECT, higher E-fields in regions-of-interest were significantly associated with greater visual retrograde memory side-effects (hippocampi: r = −0.77, p = .04; inferior frontal gyri: r = −0.92, p < .01; middle frontal gyri: r = −0.84, p = .02). Conclusions: Modification of pulse-width had greater effects than electrode placement for reducing retrograde memory side-effects with RUL ECT. Preliminary findings suggested that higher E-fields may be associated with greater cognitive side-effects with ECT.Donel M. MartinAzam Ahmad BakirFeng LinRohan Francis-TaylorAbdulrahman AlduraywishSiwei BaiDusan Hadzi-PavlovicSocrates DokosColleen K. LooElsevierarticleElectroconvulsive therapyRight unilateralPulse widthMemoryComputational modellingNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENBrain Stimulation, Vol 14, Iss 6, Pp 1489-1497 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Electroconvulsive therapy Right unilateral Pulse width Memory Computational modelling Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	Electroconvulsive therapy Right unilateral Pulse width Memory Computational modelling Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Donel M. Martin Azam Ahmad Bakir Feng Lin Rohan Francis-Taylor Abdulrahman Alduraywish Siwei Bai Dusan Hadzi-Pavlovic Socrates Dokos Colleen K. Loo Effects of modifying the electrode placement and pulse width on cognitive side effects with unilateral ECT: A pilot randomised controlled study with computational modelling
description	Background: The electrode placement and pulse width for electroconvulsive therapy (ECT) are important treatment parameters associated with ECT related retrograde memory side-effects. Modification of these parameters with right unilateral (RUL) ECT may have utility for further reducing these side-effects. Objective: This study explored use of the frontoparietal (FP) placement for reducing retrograde memory side effects with ECT. We hypothesised that superior retrograde memory outcomes would occur with FP compared to temporoparietal (TP) placement and with ultrabrief (UB: 0.3 ms) compared to brief pulse (BP: 1.0 ms) width ECT. Methods: In this randomised cross-over, double-blinded study, participants received a single treatment of BP TP, BP FP, UB TP and UB FP ECT. Neuropsychological testing was conducted prior to and immediately following each treatment. Computational modelling was conducted to explore associations between E-fields in regions-of-interest associated with memory. Results: Nine participants completed the study. The FP placement was not superior to TP for retrograde memory outcomes. For both electrode placements UB pulse width was associated with significantly better visual retrograde memory compared to BP (p < .05). With TP ECT, higher E-fields in regions-of-interest were significantly associated with greater visual retrograde memory side-effects (hippocampi: r = −0.77, p = .04; inferior frontal gyri: r = −0.92, p < .01; middle frontal gyri: r = −0.84, p = .02). Conclusions: Modification of pulse-width had greater effects than electrode placement for reducing retrograde memory side-effects with RUL ECT. Preliminary findings suggested that higher E-fields may be associated with greater cognitive side-effects with ECT.
format	article
author	Donel M. Martin Azam Ahmad Bakir Feng Lin Rohan Francis-Taylor Abdulrahman Alduraywish Siwei Bai Dusan Hadzi-Pavlovic Socrates Dokos Colleen K. Loo
author_facet	Donel M. Martin Azam Ahmad Bakir Feng Lin Rohan Francis-Taylor Abdulrahman Alduraywish Siwei Bai Dusan Hadzi-Pavlovic Socrates Dokos Colleen K. Loo
author_sort	Donel M. Martin
title	Effects of modifying the electrode placement and pulse width on cognitive side effects with unilateral ECT: A pilot randomised controlled study with computational modelling
title_short	Effects of modifying the electrode placement and pulse width on cognitive side effects with unilateral ECT: A pilot randomised controlled study with computational modelling
title_full	Effects of modifying the electrode placement and pulse width on cognitive side effects with unilateral ECT: A pilot randomised controlled study with computational modelling
title_fullStr	Effects of modifying the electrode placement and pulse width on cognitive side effects with unilateral ECT: A pilot randomised controlled study with computational modelling
title_full_unstemmed	Effects of modifying the electrode placement and pulse width on cognitive side effects with unilateral ECT: A pilot randomised controlled study with computational modelling
title_sort	effects of modifying the electrode placement and pulse width on cognitive side effects with unilateral ect: a pilot randomised controlled study with computational modelling
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/3c8469597a384a33a86d53a6dc94a962
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Effects of modifying the electrode placement and pulse width on cognitive side effects with unilateral ECT: A pilot randomised controlled study with computational modelling

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