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. 2024 Apr;69(4):288-295.
doi: 10.1177/07067437231223340. Epub 2023 Dec 28.

Comparing Methods of Seizure Response Monitoring During Electroconvulsive Therapy: Comparer les méthodes de surveillance des interventions en cas de crise durant la thérapie par électrochocs

Timothy Hierlihy  1 , Gerald Mugford  1 , Weldon Bonnell  1 , Mohamed A Mekawy  1
Affiliations

Comparing Methods of Seizure Response Monitoring During Electroconvulsive Therapy: Comparer les méthodes de surveillance des interventions en cas de crise durant la thérapie par électrochocs

Timothy Hierlihy et al. Can J Psychiatry. 2024 Apr.

Abstract
in English, French

Objective: Electroconvulsive therapy (ECT) is used to treat several mental illnesses. Seizure duration is used to determine if the administered stimulus was adequate. Duration is estimated by electroencephalogram (EEG) interpretation and/or observed motor response (OMR). Neither method is considered the gold standard. This study investigated the relationship between the 2 methods. The hypothesis was that both EEG and OMR would be significantly positively correlated. Previous researchers have suggested that the 2 methods resulted in different estimates.

Methods: A case series was conducted using recorded estimates obtained prospectively from 102 ECTs on adult psychiatric inpatients.

Results: A strong positive association was not observed in this study, correlation coefficient 0.510 (p < 0.001).

Conclusions: This study suggests that the 2 methods differ, and further research is needed to determine the best indicator of adequate treatment.

Objectif: La thérapie par électrochocs (ECT) est indiquée dans plusieurs maladies mentales. La durée de la crise est utilisée pour déterminer si le stimulus administré était adéquat. La durée est estimée par l’interprétation de l’électro-encéphalogramme (EEG) et/ou de la réponse motrice observée (OMR). Aucune des deux méthodes n’est considérée l’étalon-or. La présente étude a investigué la relation entre les deux méthodes. L’hypothèse avançait que l’EEG et l’OMR seraient significativement et positivement corrélées. Les recherches antérieures ont suggéré que les deux méthodes résultaient en des estimations différentes.

Méthodes: Une série de cas a été menée à l’aide d’estimations enregistrées obtenues prospectivement de 102 ECT sur des patients adultes psychiatriques hospitalisés.

Résultats: Une forte association positive n’a pas été observée dans cette étude.

Conclusions: La présente étude suggère que les deux méthodes diffèrent, et qu’il faut plus de recherche pour déterminer le meilleur indicateur du traitement adéquat.

Keywords: ECT, choc électroconvulsif; EEG, électro-encéphalogramme; crise; electroconvulsive shock; electroconvulsive therapy (ECT); electroencephalogram (EEG); electroencephalography; seizure; thérapie par électrochocs; électro-encéphalographie.

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Conflict of interest statement

Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Difference against mean for seizure estimation of both methods.
Figure 2.
Figure 2.
Estimated seizure duration with linear regression line included.
Figure 3.
Figure 3.
Scatter plot of electroencephalogram (EEG) and motor response including reference lines that represent the minimum duration of adequate seizure duration (15 s).
See this image and copyright information in PMC

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