Lee Won Hee, Deng Zhi-De, Kim Tae-Seong, Laine Andrew F, Lisanby Sarah H, Peterchev Angel V
Department of Biomedical Engineering, Columbia University, New York, NY 10032, USA.
Annu Int Conf IEEE Eng Med Biol Soc. 2010;2010:2045-8. doi: 10.1109/IEMBS.2010.5626553.
The goal of this study is to investigate the regional distribution of the electric field (E-field) strength induced by electroconvulsive therapy (ECT), and to contrast clinically relevant electrode configurations through finite element (FE) analysis. An FE human head model incorporating tissue heterogeneity and white matter anisotropy was generated based on structural magnetic resonance imaging (MRI) and diffusion tensor MRI (DT-MRI) data. We simulated the E-field spatial distributions of three standard ECT electrode placements [bilateral (BL), bifrontal (BF), and right unilateral (RUL)] and an investigational electrode configuration [focal electrically administered seizure therapy (FEAST)]. A quantitative comparison of the E-field strength was subsequently carried out in various brain regions of interests (ROIs) that have putative role in the therapeutic action and/or adverse side effects of ECT. This study illustrates how the realistic FE head model provides quantitative insight in the biophysics of ECT, which may shed light on the differential clinical outcomes seen with various forms of ECT, and may guide the development of novel stimulation paradigms with improved risk/benefit ratio.
本研究的目的是调查电休克治疗（ECT）所诱导的电场（E场）强度的区域分布，并通过有限元（FE）分析对比临床相关的电极配置。基于结构磁共振成像（MRI）和扩散张量MRI（DT-MRI）数据生成了一个包含组织异质性和白质各向异性的有限元人体头部模型。我们模拟了三种标准ECT电极放置方式[双侧（BL）、双额（BF）和右侧单侧（RUL）]以及一种研究性电极配置[局灶性电惊厥治疗（FEAST）]的E场空间分布。随后在ECT的治疗作用和/或不良副作用中具有假定作用的各个感兴趣脑区（ROI）中对E场强度进行了定量比较。本研究说明了逼真的有限元头部模型如何为ECT的生物物理学提供定量见解，这可能有助于解释不同形式ECT所观察到的不同临床结果，并可能指导开发具有改善风险/效益比的新型刺激模式。
