Lee Won Hee, Lisanby Sarah H, Laine Andrew F, Peterchev Angel V
Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA.
Annu Int Conf IEEE Eng Med Biol Soc. 2012;2012:6430-3. doi: 10.1109/EMBC.2012.6347466.
This study investigates the stimulation strength and focality of electroconvulsive therapy (ECT) with individualized current amplitude in a nonhuman primate (NHP) model. We generated an anatomically realistic finite element model of a NHP head incorporating tissue heterogeneity and white matter conductivity anisotropy based on structural magnetic resonance imaging (MRI) and diffusion tensor MRI data. The electric field spatial distributions of three conventional ECT electrode placements (bilateral, bifrontal, and right unilateral) and an experimental frontomedial electrode configuration were simulated. We calibrated the electric field maps relative to an empirical neural activation threshold and evaluated the stimulation strength and focality of the various ECT electrode configurations with individualized current amplitudes corresponding to the motor threshold and seizure threshold assessed in the anesthetized NHP. Understanding the stimulation strength and focality of various forms of ECT could provide insight into the mechanisms of therapeutic seizure induction, and could provide support for the clinical investigation of ECT with individualized current amplitude as an intervention with potentially improved risk/benefit ratio.
本研究在非人灵长类（NHP）模型中，研究了采用个体化电流幅度的电惊厥治疗（ECT）的刺激强度和聚焦性。我们基于结构磁共振成像（MRI）和扩散张量MRI数据，生成了一个包含组织异质性和白质电导率各向异性的NHP头部解剖学逼真的有限元模型。模拟了三种传统ECT电极放置方式（双侧、双额和右侧单侧）以及一种实验性额内侧电极配置的电场空间分布。我们相对于经验性神经激活阈值校准了电场图，并评估了各种ECT电极配置在与麻醉的NHP中评估的运动阈值和癫痫发作阈值相对应的个体化电流幅度下的刺激强度和聚焦性。了解各种形式的ECT的刺激强度和聚焦性，可以深入了解治疗性癫痫发作诱导的机制，并可为以个体化电流幅度作为一种可能改善风险/效益比的干预措施的ECT临床研究提供支持。
