Impact of modeled field of view in electroconvulsive therapy current flow simulations.
Impact of modeled field of view in electroconvulsive therapy current flow simulations.
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DOI：
10.3389/fpsyt.2023.1168672
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发表时间：
2023
影响因子：
4.7
通讯作者：
Datta, Abhishek
中科院分区：
文献类型：
--
作者：
Guillen, Alexander;Abbott, Christopher C.;Deng, Zhi-De;Huang, Yu;Pascoal-Faria, Paula;Truong, Dennis Q.;Datta, Abhishek
正如预期，在MRI引导的电休克治疗（ECT）正向模型中考虑的视野（FOV）仅限于收集的MRI体积。因此，在模拟工作中考虑的模型范围存在变化。本研究检查了FOV对两种常见电极放置（右侧单侧（RUL）和双侧（BL））引起的感应电场（E场）的影响。获得并处理全身数据集，用于与ECT物理学相关的建模。通过从头部向下截断到四个级别来导出多个范围：上头部（全脑）、整个头部、颈部和躯干。确定了所有相关刺激和局灶性指标。将每种程度与全身（参考）模型之间大脑中刺激强度第99百分位数峰值的差异视为相对误差（RE）。我们还确定FOV，超过该FOV，与全身模型的差异将可以忽略不计。2D和3D空间图显示了与先前工作一致的预期结果。BL上头部的RE约为50%，颈部FOV的RE约为2%。RUL上头部的RE约为5%，降低至全头部FOV的亚百分比（0.28%）。如前所述，BL被发现刺激更大的大脑体积，但仅限于上头部，幅度高达~480 mA。在某种程度上，RUL刺激了更大的交易量。如果ECT幅度>270 mA，则即使考虑与短脉冲BL对应的神经激活阈值，RUL诱导的体积也较大。当考虑更多的视野时，BL通过下部区域引起的电流损失可以解释这一发现。我们的结果是偏离先前的努力，并提出了问题的焦点度量定义和/或个体间的差异。我们的研究结果强调，在FOV方面，BL比RUL受到的影响更大。对于任何BL模拟和可能更多的模拟，必须至少收集全水头数据。当RUL不成功时，临床实践诉诸于使用BL ECT。然而，BL在刺激更多脑容量的前提下更有效的概念需要重新审视。
The field of view (FOV) considered in MRI-guided forward models of electroconvulsive therapy (ECT) are, as expected, limited to the MRI volume collected. Therefore, there is variation in model extent considered across simulation efforts. This study examines the impact of FOV on the induced electric field (E-field) due to two common electrode placements: right unilateral (RUL) and bilateral (BL). A full-body dataset was obtained and processed for modeling relevant to ECT physics. Multiple extents were derived by truncating from the head down to four levels: upper head (whole-brain), full head, neck, and torso. All relevant stimulation and focality metrics were determined. The differences in the 99th percentile peak of stimulation strength in the brain between each extent to the full-body (reference) model were considered as the relative error (RE). We also determine the FOV beyond which the difference to a full-body model would be negligible. The 2D and 3D spatial plots revealed anticipated results in line with prior efforts. The RE for BL upper head was ~50% reducing to ~2% for the neck FOV. The RE for RUL upper head was ~5% reducing to subpercentage (0.28%) for the full-head FOV. As shown previously, BL was found to stimulate a larger brain volume—but restricted to the upper head and for amplitude up to ~480 mA. To some extent, RUL stimulated a larger volume. The RUL-induced volume was larger even when considering the neural activation threshold corresponding to brief pulse BL if ECT amplitude was >270 mA. This finding is explained by the BL-induced current loss through the inferior regions as more FOV is considered. Our result is a departure from prior efforts and raises questions about the focality metric as defined and/or inter-individual differences. Our findings highlight that BL is impacted more than RUL with respect to FOV. It is imperative to collect full-head data at a minimum for any BL simulation and possibly more. Clinical practice resorts to using BL ECT when RUL is unsuccessful. However, the notion that BL is more efficacious on the premise of stimulating more brain volume needs to be revisited.
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DOI：
10.1109/tbme.2015.2425406
发表时间：
2015-09
期刊：
IEEE transactions on bio-medical engineering
影响因子：
--
作者：
Lee WH;Lisanby SH;Laine AF;Peterchev AV
通讯作者：
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影响因子：
7.7
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10.1016/j.eurpsy.2016.03.003
发表时间：
2016-08
期刊：
European psychiatry : the journal of the Association of European Psychiatrists
影响因子：
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作者：
Lee WH;Lisanby SH;Laine AF;Peterchev AV
通讯作者：
Peterchev AV
影响因子：
7.7
作者：
Argyelan, Miklos;Oltedal, Leif;Abbott, Christopher
通讯作者：
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