title: Quick recovery of orientation after magnetic seizure therapy for major depressive disorder.
abstract: BACKGROUND
  Magnetic seizure therapy, in which seizures are elicited with a high-frequency magnetic field, is under development as a new treatment for major depressive disorder. Its use may be justified if it produces the antidepressant effects of electroconvulsive therapy (ECT), coupled with limited cognitive side-effects.
  
  
  OBJECTIVE
  To evaluate the usefulness of a new 100 Hz magnetic seizure therapy device.
  
  
  METHODS
  We induced seizures with 100 Hz magnetic transcranial stimulation in 11 patients with major depressive disorder during one session of a regular course of ECT. Recovery times after seizures induced by magnetic seizure therapy and ECT were compared.
  
  
  RESULTS
  Seizures could be elicited in 10 of the 11 patients. Stimulation over the vertex produced tonic-clonic activity on 9 out of 11 occasions. Stimulation over the prefrontal midpoint elicited seizures on 3 out of 7 occasions. The mean duration of magnetically induced seizures was 31.3 s, ranging from 10 to 86 s. All patients had an exceptionally quick recovery of orientation: mean of 7 min 12 s (s.d.=2 min 7 s, range 4 min 20 s to 9 min 41 s). The recovery times were on average 15 min 35 s shorter with magnetic seizure therapy than with ECT in the same patients (paired-samples t-test: P<0.0001). Patients reported feeling less confused after magnetic seizure therapy. Side-effects were confined to myoclonic movements, associated with the use of etomidate.
  
  
  CONCLUSIONS
  The new 100 Hz magnetic stimulator elicits seizures in the majority of patients when administered over the vertex. Magnetic seizure therapy was associated with shorter recovery times and less confusion following treatment. Subsequent work will be required to assess the safety and effectiveness of magnetic seizure therapy in the treatment of depression.
authors.affiliation: Cardiff University, Henry Wellcome Building, Heath Park, Cardiff, UK.
authors.forename: George
authors.initials: G
authors.lastname: Kirov
authors.forename: Klaus P
authors.initials: KP
authors.lastname: Ebmeier
authors.forename: Allan I F
authors.initials: AI
authors.lastname: Scott
authors.forename: Maria
authors.initials: M
authors.lastname: Atkins
authors.forename: Najeeb
authors.initials: N
authors.lastname: Khalid
authors.forename: Lucy
authors.initials: L
authors.lastname: Carrick
authors.forename: Andrew
authors.initials: A
authors.lastname: Stanfield
authors.forename: Ronan E
authors.initials: RE
authors.lastname: O'Carroll
authors.forename: Mustafa M
authors.initials: MM
authors.lastname: Husain
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Lisanby
mesh_terms: D000328:Adult; D000368:Aged; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods* / Q000523:psychology; D004574:Electromagnetic Fields; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009949:Orientation / Q000502:physiology*; D010865:Pilot Projects; D012606:Scotland; D012640:Seizures / Q000628:therapy*; D013223:Statistics as Topic; D050781:Transcranial Magnetic Stimulation / Q000379:methods* / Q000523:psychology; D014852:Wales