Optimizing ECT With E-Field Modeling: A Narrative Review in JECT

 Out on PubMed, from authors in China and the US, is this article:

Optimizing Electroconvulsive Therapy With E-Field Modeling: A Narrative Review.

Ren C, Kung S, Croarkin PE, Opitz A, Forester BP, Hermida AP, Mueller M, Pagali SR, Petrides G, Seiner SJ, Yoon IA, Lapid MI.J ECT. 2025 Jan 24. doi: 10.1097/YCT.0000000000001111. Online ahead of print.PMID: 39853304
The abstract is copied below:
Electroconvulsive therapy (ECT) is an effective treatment for severe depression, especially in treatment-resistant cases. However, its potential cognitive side effects necessitate careful dosing to balance therapeutic benefits and cognitive stability. Recent advances in electric field (E-field) modeling offer promising avenues to optimize ECT dosing. This review synthesizes current knowledge on E-field modeling in ECT and explores its clinical applications. It examines the variability in E-field strengths and distributions induced by ECT and their impact on clinical outcomes. Additionally, the relationship between E-field strengths, neuroplasticity, and therapeutic efficacy is discussed. Translational studies of E-field-informed ECT are highlighted, emphasizing individualized optimal amplitude dosing and potential clinical applications. This review provides useful insights into how E-field modeling can improve the effectiveness of ECT while minimizing adverse effects, helping guide future research and clinical practice.

The article is here.
And from the text:

If you are a fan of E-field modeling to guide stimulus dosing in ECT, then this article is for you. It is a fine review of this theory-based idea, summarizing the current literature, scant though it may be. I do fault the authors a bit for elevating the issue of temporary cognitive effects to such a high level, which, in the wrong hands, can be used as an argument against ECT. I also wish that they would use the term "cognitive tolerability" rather than "cognitive safety." 

Comments

Post a Comment

Popular posts from this blog

ECT plus Antidepressants: a Review

Out on PubMed, from researchers in Rotterdam, The Netherlands, is this review: Influence of an adjuvant antidepressant on the efficacy of  electroconvulsive  therapy: A systematic review and meta-analysis. Pluijms EM, Kamperman AM, Hoogendijk WJ, Birkenhäger TK, van den Broek WW. Aust N Z J Psychiatry. 2020 Sep 8:4867420952543. doi: 10.1177/0004867420952543. Online ahead of print. PMID:  32900217 Here is the "Conclusion" section from the text: Our results suggest that an adjuvant antidepressant enhances the efficacy of ECT in patients with major depression. Although the included studies had some methodological limitations, effect sizes were consistently small to moderate. We speculate that modern-day controlled trials using adequately dosed TCAs and MAOIs will most likely result in larger effect sizes. From a clinical point of view, we prefer an adjuvant TCA to an adjuvant MAOI, since TCAs are generally safe to use with ECT ( American Psychiatric Association, 2001 ; ...
Read more

Happy Birthday to Max Fink!

Image
Happy 102nd birthday to Max Fink, MD! Max Fink, an icon in our field, is one of the most influential ECT researchers, practitioners and advocates of all time. He has also been a friend and mentor to many of us in the ECT world, and we owe him a great debt of gratitude. Please join me in wishing him all the best today!                                                    Max Fink, October 2024, with Andrea and Charles Kellner
Read more

Early Use of the Name "ECT"- Sacklers in 1949

Image
 "Classics in ECT" brings you this study from Creedmore State Hospital in 1949: Nonconvulsive biochemotherapy with histamine and electric convulsive therapy; a comparative study on hospitalized psychotics with a control  ECT  series. SACKLER AM, SACKLER MD, SACKLER RR. J Nerv Ment Dis. 1949 Sep;110(3):185-97. doi: 10.1097/00005053-194911030-00001. PMID:  18138865 The pdf is here . I originally choose this article as the earliest in PubMed to use the name, "ECT," although it also uses "electric [sic] convulsive therapy."  The very first PubMed "ECT" citation is from 1947, but it is written "E.C.T." and also reports a complication, so we prefer this one. Nomenclature aside, this turns out to be an interesting read, with what would now be considered a somewhat bizarre study comparing histamine therapy with ECT. Among the interesting details are the inclusion of a couple of patients with postpartum psychosis and the observation that longer ...
Read more