Electric field strength induced by electroconvulsive therapy is associated with clinical outcome

Egill Axfjord Fridgeirsson; Zhi-De Deng; Damiaan Denys; Jeroen A van Waarde; Guido A van Wingen

doi:10.1016/j.nicl.2021.102581

Electric field strength induced by electroconvulsive therapy is associated with clinical outcome

Egill Axfjord Fridgeirsson, Zhi-De Deng, Damiaan Denys, Jeroen A van Waarde, Guido A van Wingen

Netherlands Institute for Neuroscience (NIN)

Research output: Contribution to journal/periodical › Article › Scientific › peer-review

15 Downloads (Pure)

Abstract

The clinical effect of electroconvulsive therapy (ECT) is mediated by eliciting a generalized seizure, which is achieved by applying electrical current to the head via scalp electrodes. The anatomy of the head influences the distribution of current flow in each brain region. Here, we investigated whether individual differences in simulated local electrical field strength are associated with ECT efficacy. We modeled the electric field of 67 depressed patients receiving ECT. Patient's T1 magnetic resonance images were segmented, conductivities were assigned to each tissue and the finite element method was used to solve for the electric field induced by the electrodes. We investigated the correlation between modelled electric field and ECT outcome using voxel-wise general linear models. The difference between bilateral (BL) and right unilateral (RUL) electrode placement was striking. Even within electrode configuration, there was substantial variability between patients. For the modeled BL placement, stronger electric field strengths appeared in the left hemisphere and part of the right temporal lobe. Importantly, a stronger electric field in the temporal lobes was associated with less optimal ECT response in patients treated with BL-ECT. No significant differences in electric field distributions were found between responders and non-responders to RUL-ECT. These results suggest that overstimulation of the temporal lobes during BL stimulation has negative consequences on treatment outcome. If replicated, individualized pre-ECT computer-modelled electric field distributions may inform the development of patient-specific ECT protocols.

Original language	English
Pages (from-to)	102581
Journal	Neuroimage. Clinical
Volume	30
DOIs	https://doi.org/10.1016/j.nicl.2021.102581
Publication status	E-pub ahead of print - 2021

Access to Document

10.1016/j.nicl.2021.102581

fridg2021Final published version, 11.4 MB

Fingerprint Dive into the research topics of 'Electric field strength induced by electroconvulsive therapy is associated with clinical outcome'. Together they form a unique fingerprint.

Cite this

@article{4dfabc595204483e8dc6ec9ccf82f972,

title = "Electric field strength induced by electroconvulsive therapy is associated with clinical outcome",

abstract = "The clinical effect of electroconvulsive therapy (ECT) is mediated by eliciting a generalized seizure, which is achieved by applying electrical current to the head via scalp electrodes. The anatomy of the head influences the distribution of current flow in each brain region. Here, we investigated whether individual differences in simulated local electrical field strength are associated with ECT efficacy. We modeled the electric field of 67 depressed patients receiving ECT. Patient's T1 magnetic resonance images were segmented, conductivities were assigned to each tissue and the finite element method was used to solve for the electric field induced by the electrodes. We investigated the correlation between modelled electric field and ECT outcome using voxel-wise general linear models. The difference between bilateral (BL) and right unilateral (RUL) electrode placement was striking. Even within electrode configuration, there was substantial variability between patients. For the modeled BL placement, stronger electric field strengths appeared in the left hemisphere and part of the right temporal lobe. Importantly, a stronger electric field in the temporal lobes was associated with less optimal ECT response in patients treated with BL-ECT. No significant differences in electric field distributions were found between responders and non-responders to RUL-ECT. These results suggest that overstimulation of the temporal lobes during BL stimulation has negative consequences on treatment outcome. If replicated, individualized pre-ECT computer-modelled electric field distributions may inform the development of patient-specific ECT protocols.",

author = "Fridgeirsson, {Egill Axfjord} and Zhi-De Deng and Damiaan Denys and {van Waarde}, {Jeroen A} and {van Wingen}, {Guido A}",

year = "2021",

doi = "10.1016/j.nicl.2021.102581",

language = "English",

volume = "30",

pages = "102581",

journal = "NeuroImage: Clinical",

issn = "2213-1582",

publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Electric field strength induced by electroconvulsive therapy is associated with clinical outcome

AU - Fridgeirsson, Egill Axfjord

AU - Deng, Zhi-De

AU - Denys, Damiaan

AU - van Waarde, Jeroen A

AU - van Wingen, Guido A

PY - 2021

Y1 - 2021

N2 - The clinical effect of electroconvulsive therapy (ECT) is mediated by eliciting a generalized seizure, which is achieved by applying electrical current to the head via scalp electrodes. The anatomy of the head influences the distribution of current flow in each brain region. Here, we investigated whether individual differences in simulated local electrical field strength are associated with ECT efficacy. We modeled the electric field of 67 depressed patients receiving ECT. Patient's T1 magnetic resonance images were segmented, conductivities were assigned to each tissue and the finite element method was used to solve for the electric field induced by the electrodes. We investigated the correlation between modelled electric field and ECT outcome using voxel-wise general linear models. The difference between bilateral (BL) and right unilateral (RUL) electrode placement was striking. Even within electrode configuration, there was substantial variability between patients. For the modeled BL placement, stronger electric field strengths appeared in the left hemisphere and part of the right temporal lobe. Importantly, a stronger electric field in the temporal lobes was associated with less optimal ECT response in patients treated with BL-ECT. No significant differences in electric field distributions were found between responders and non-responders to RUL-ECT. These results suggest that overstimulation of the temporal lobes during BL stimulation has negative consequences on treatment outcome. If replicated, individualized pre-ECT computer-modelled electric field distributions may inform the development of patient-specific ECT protocols.

AB - The clinical effect of electroconvulsive therapy (ECT) is mediated by eliciting a generalized seizure, which is achieved by applying electrical current to the head via scalp electrodes. The anatomy of the head influences the distribution of current flow in each brain region. Here, we investigated whether individual differences in simulated local electrical field strength are associated with ECT efficacy. We modeled the electric field of 67 depressed patients receiving ECT. Patient's T1 magnetic resonance images were segmented, conductivities were assigned to each tissue and the finite element method was used to solve for the electric field induced by the electrodes. We investigated the correlation between modelled electric field and ECT outcome using voxel-wise general linear models. The difference between bilateral (BL) and right unilateral (RUL) electrode placement was striking. Even within electrode configuration, there was substantial variability between patients. For the modeled BL placement, stronger electric field strengths appeared in the left hemisphere and part of the right temporal lobe. Importantly, a stronger electric field in the temporal lobes was associated with less optimal ECT response in patients treated with BL-ECT. No significant differences in electric field distributions were found between responders and non-responders to RUL-ECT. These results suggest that overstimulation of the temporal lobes during BL stimulation has negative consequences on treatment outcome. If replicated, individualized pre-ECT computer-modelled electric field distributions may inform the development of patient-specific ECT protocols.

U2 - 10.1016/j.nicl.2021.102581

DO - 10.1016/j.nicl.2021.102581

M3 - Article

C2 - 33588322

VL - 30

SP - 102581

JO - NeuroImage: Clinical

JF - NeuroImage: Clinical

SN - 2213-1582

ER -