Electric field strength and focality in electroconvulsive therapy and magnetic seizure therapy: a finite element simulation study
Electric field strength and focality in electroconvulsive therapy and magnetic seizure therapy: a finite element simulation study
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DOI：
10.1088/1741-2560/8/1/016007
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发表时间：
2011-02-01
影响因子：
4
通讯作者：
Peterchev, Angel V.
中科院分区：
文献类型：
--
作者：
Deng, Zhi-De;Lisanby, Sarah H.;Peterchev, Angel V.
我们提出了第一个计算研究比较各种电休克治疗（ECT）和磁惊厥治疗（MST）范式引起的电场。对四种ECT电极配置（双侧、双额叶、右侧单侧和局灶性电管理癫痫发作治疗）和三种MST线圈配置（圆形、帽形和双锥形）进行建模。该模型采用了特定于模态的神经激活阈值。ECT（0.3ms脉宽）和MST在脑内产生的最大电场为2.1- 2.5V cm（-1）和1.1- 2.2V cm（-1），分别相当于神经激活阈值的6.2-7.2倍和1.2-2.3倍。与ECT相比，MST电场更局限于表层皮层。ECT刺激的脑体积（高达100%）比MST（高达8.2%）大得多。双锥线圈的MST病灶最大，双侧ECT病灶最小。我们的研究结果表明，一个可能的生物物理解释减少副作用的MST相比，ECT。我们的研究结果还表明，传统的ECT脉冲幅度（800-900毫安）是远远高于癫痫发作诱导所需的。应探索降低ECT脉冲幅度作为减少副作用的潜在方法。
We present the first computational study comparing the electric field induced by various electroconvulsive therapy (ECT) and magnetic seizure therapy (MST) paradigms. Four ECT electrode configurations (bilateral, bifrontal, right unilateral, and focal electrically administered seizure therapy) and three MST coil configurations (circular, cap, and double cone) were modeled. The model incorporated a modality-specific neural activation threshold. ECT (0.3 ms pulse width) and MST induced the maximum electric field of 2.1-2.5 V cm(-1) and 1.1-2.2 V cm(-1) in the brain, corresponding to 6.2-7.2 times and 1.2-2.3 times the neural activation threshold, respectively. The MST electric field is more confined to the superficial cortex compared to ECT. The brain volume stimulated was much larger with ECT (up to 100%) than with MST (up to 8.2%). MST with the double-cone coil was the most focal, and bilateral ECT was the least focal. Our results suggest a possible biophysical explanation of the reduced side effects of MST compared to ECT. Our results also indicate that the conventional ECT pulse amplitude (800-900 mA) is much higher than necessary for seizure induction. Reducing the ECT pulse amplitude should be explored as a potential means of diminishing side effects.