Zhong Gangliang, Zhang Guanghao, Ren Yanping, Zhang Cheng, Wu Changzhe, Jang Wei, Huo Xiaolin
Beijing Key Laboratory of Bioelectromagnetism, Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing 100190, P.R.China;School of Electronics, Electrical and Communication Engineering, University of Chinese Academy of Sciences, Beijing 100049, P.R.China.
Beijing Key Laboratory of Bioelectromagnetism, Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing 100190, P.R.China.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2018 Aug 25;35(4):564-570. doi: 10.7507/1001-5515.201712067.
Modified electroconvulsive therapy (MECT) and magnetic seizure therapy (MST) are effective treatments for severe major depression. MECT has better efficacy in the treatment than MST, but it has cognitive and memorial side effects while MST does not. To study the causes of these different outcomes, this study contrasted the electric filed strength and spatial distribution induced by MECT and MST in a realistic human head model. Electric field strength induced by MECT and MST are simulated by the finite element method, which was based on a realistic human head model obtained by magnetic resonance imaging. The electrode configuration of MECT is standard bifrontal stimulation configuration, and the coil configuration of MST is circular. Maps of the ratio of the electric field strength to neural activation threshold are obtained to evaluate the stimulation strength and stimulation focality in brain regions. The stimulation strength induced by MECT is stronger than MST, and the activated region is wider. MECT stimulation strength in gray matter is 17.817 times of that by MST, and MECT stimulation strength in white matter is 23.312 times of that by MST. As well, MECT stimulation strength in hippocampi is 35.162 times of that by MST. More than 99.999% of the brain volume is stimulated at suprathreshold by MECT. However, MST activated only 0.700% of the brain volume. The stimulation strength induced by MECT is stronger than MST, and the activated region is wider may be the reason that MECT has better effectiveness. Nevertheless, the stronger stimulation strength in hippocampi induced by MECT may be the reason that MECT is more likely to give rise to side effects. Based on the results of this study, it is expected that a more accurate clinical quantitative treatment scheme should be studied in the future.
改良电休克治疗(MECT)和磁休克治疗(MST)是重度重度抑郁症的有效治疗方法。MECT在治疗中的疗效优于MST,但它有认知和记忆方面的副作用,而MST没有。为了研究这些不同结果的原因,本研究在逼真的人体头部模型中对比了MECT和MST诱导的电场强度和空间分布。通过有限元方法模拟了MECT和MST诱导的电场强度,该方法基于通过磁共振成像获得的逼真人体头部模型。MECT的电极配置是标准的双额叶刺激配置,MST的线圈配置是圆形的。获得电场强度与神经激活阈值的比值图,以评估脑区的刺激强度和刺激聚焦性。MECT诱导的刺激强度比MST强,激活区域更宽。MECT在灰质中的刺激强度是MST的17.817倍,MECT在白质中的刺激强度是MST的23.312倍。同样,MECT在海马体中的刺激强度是MST的35.162倍。MECT在阈上刺激了超过99.999%的脑容量。然而,MST仅激活了0.700%的脑容量。MECT诱导的刺激强度比MST强,激活区域更宽可能是MECT具有更好疗效的原因。然而,MECT在海马体中诱导的更强刺激强度可能是MECT更容易产生副作用的原因。基于本研究结果,预计未来应研究更准确的临床定量治疗方案。