Ictal EEG fractal dimension in ECT predicts outcome at 2 weeks in schizophrenia

The ictal EEG in ECT: A systematic review of the relationships between ictal features, ECT technique, seizure threshold and outcomes

OBJECTIVE

To provide guidance for ECT practitioners in utilising the ictal EEG to inform treatment decisions.

METHODS

A systematic review of studies examining the ictal EEG, treatment technique, seizure threshold and treatment outcomes was conducted. MEDLINE, EMBASE and PsycINFO databases were searched up to July 31, 2019. Studies were included if they examined the use of ECT in human subjects and compared an ictal EEG analysis (either quantitative or manually rated) with either: a) clinical outcomes, b) seizure threshold/threshold change, c) ECT dosing decisions, or d) different aspects of ECT technique (comparison of different electrode placements, pulse widths, waveforms, or dose/dose relative to seizure threshold).

RESULTS

A total of 853 studies were identified, with 44 meeting inclusion criteria. A qualitative review revealed ictal EEG indices have been linked to therapeutic outcome, though the strength of this relationship appears modest. Ictal EEG features are influenced by variations in ECT treatment technique. Serial ictal EEG monitoring can detect changes in seizure threshold across an ECT course for right unilateral brief and ultrabrief pulse ECT.

CONCLUSION

While there is some relationship between ictal EEG manifestation and treatment outcomes, the primary utility of ictal EEG monitoring during an ECT course may lie in the capacity to detect changes in seizure threshold and adjust dosing accordingly. Prospective validation of a dosing regime informed by serial ictal EEG monitoring is warranted.

Evaluation of divided attention using different stimulation models in event-related potentials

Divided attention is defined as focusing on different tasks at once, and this is described as one of the biggest problems of today's society. Default examinations for understanding attention are questionnaires or physiological signals, like evoked potentials and electroencephalography. Physiological records were obtained using visual, auditory, and auditory-visual stimuli combinations with 48 participants-18-25-year-old university students-to find differences between sustained and divided attention. A Fourier-based filter was used to get a 0.01-30-Hz frequency band. Fractal dimensions, entropy values, power spectral densities, and Hjorth parameters from electroencephalography and P300 components from evoked potentials were calculated as features. To decrease the size of the feature set, some features, which yield less detail level for data, were eliminated. The visual and auditory stimuli in selective attention were compared with the divided attention state, and the best accuracy was found to be 88.89% on a support vector machine with linear kernel. As a result, it was seen that divided attention could be more difficult to determine from selective attention, but successful classification could be obtained with appropriate methods. Contrary to literature, the study deals with the infrastructure of attention types by working on a completely healthy and attention-high group. Graphical abstract.

Two decades of an indigenously developed brief-pulse electroconvulsive therapy device: A review of research work from National Institute of Mental Health and Neurosciences

In 1993, a device to administer brief-pulse electroconvulsive therapy was indigenously developed through collaboration between the National Institution for Quality and Reliability and the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India. The additional feature of computerized recording of the electroencephalograph and electrocardiograph for both online and offline use had substantial clinical and research implications. Over the past two decades, this device has been used extensively in different academic and nonacademic settings. A considerable body of research with clinical and heuristic interest has also emanated using this device. In this paper, we present the development of this device and follow it up with a review of research conducted at NIMHANS that validate the features and potentials of this device.