Deng Zhi-De, Lisanby Sarah H, Peterchev Angel V
Department of Electrical Engineering and with the Division of Brain Stimulation and Therapeutic Modulation, Department of Psychiatry, Columbia University, New York, NY 10032, USA.
Annu Int Conf IEEE Eng Med Biol Soc. 2009;2009:682-8. doi: 10.1109/IEMBS.2009.5334091.
We present a quantitative comparison of two metrics-neural stimulation strength and focality-in electrocon-vulsive therapy (ECT) and magnetic seizure therapy (MST) using finite-element method (FEM) simulation in a spherical head model. Five stimulation modalities were modeled, including bilateral ECT, unilateral ECT, focal electrically administered seizure therapy (FEAST), and MST with circular and double-cone coils, with stimulation parameters identical to those applied in clinical practice. We further examine the effect on the stimulation metrics of individual-, sex- and age-related variability in tissue layer thickness and conductivity. Neural stimulation by MST is shown to be more focal and superficial than ECT. This result suggests that it may be advantageous to reduce the current used in ECT. The stimulation strength in MST is also less sensitive to variations in head geometry and tissue conductivity than in ECT. Individualization of pulse amplitude in both ECT and MST could compensate for anatomical variability, which could lead to more consistent clinical outcomes.
我们使用有限元方法（FEM）在球形头部模型中对电休克治疗（ECT）和磁休克治疗（MST）中的两种指标——神经刺激强度和聚焦性进行了定量比较。对五种刺激方式进行了建模，包括双侧ECT、单侧ECT、局灶性电诱发癫痫治疗（FEAST）以及使用圆形和双锥形线圈的MST，其刺激参数与临床实践中应用的参数相同。我们进一步研究了组织层厚度和电导率中个体、性别和年龄相关变异性对刺激指标的影响。结果表明，MST引起的神经刺激比ECT更具聚焦性且更表浅。这一结果表明，降低ECT中使用的电流可能具有优势。与ECT相比，MST中的刺激强度对头部几何形状和组织电导率变化的敏感性也更低。ECT和MST中脉冲幅度的个体化可以补偿解剖学变异性，这可能会带来更一致的临床结果。
