title: Regional cerebral blood flow changes associated with focal electrically administered seizure therapy (FEAST).
abstract: BACKGROUND
  Use of electroconvulsive therapy (ECT) is limited by cognitive disturbance. Focal electrically-administered seizure therapy (FEAST) is designed to initiate focal seizures in the prefrontal cortex. To date, no studies have documented the effects of FEAST on regional cerebral blood flow (rCBF).
  
  
  METHODS
  A 72 year old depressed man underwent three single photon emission computed tomography (SPECT) scans to capture the onset and resolution of seizures triggered with right unilateral FEAST. We used Bioimage Suite for within-subject statistical analyses of perfusion differences ictally and post-ictally compared with the baseline scan.
  
  
  RESULTS
  Early ictal increases in regional cerebral blood flow (rCBF) were limited to the right prefrontal cortex. Post-ictally, perfusion was reduced in bilateral frontal and occipital cortices and increased in left motor and precuneus cortex.
  
  
  CONCLUSIONS
  FEAST appears to triggers focal onsets of seizure activity in the right prefrontal cortex with subsequent generalization. Future studies are needed on a larger sample.
authors.affiliation: American University of Beirut, Department of Psychiatry, P.O. Box 11-0236, Riad El-Solh, 1107 2020 Beirut, Lebanon.
authors.forename: George
authors.initials: G
authors.lastname: Chahine
authors.affiliation: Brain Stimulation Laboratory, Psychiatry Department, Medical University of South Carolina, USA.
authors.forename: Baron
authors.initials: B
authors.lastname: Short
authors.affiliation: Radiology Department, Medical University of South Carolina, USA.
authors.forename: Ken
authors.initials: K
authors.lastname: Spicer
authors.affiliation: Brain Stimulation Laboratory, Psychiatry Department, Medical University of South Carolina, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Schmidt
authors.affiliation: Brain Stimulation Laboratory, Psychiatry Department, Medical University of South Carolina, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Burns
authors.affiliation: American University of Beirut, Department of Psychiatry, P.O. Box 11-0236, Riad El-Solh, 1107 2020 Beirut, Lebanon.
authors.forename: Mia
authors.initials: M
authors.lastname: Atoui
authors.affiliation: Brain Stimulation Laboratory, Psychiatry Department, Medical University of South Carolina, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: George
authors.affiliation: Department of Psychiatry, Columbia University, New York, NY, USA; Department of Radiology, Columbia University, New York, NY, USA.
authors.forename: Harold A
authors.initials: HA
authors.lastname: Sackeim
authors.affiliation: American University of Beirut, Department of Psychiatry, P.O. Box 11-0236, Riad El-Solh, 1107 2020 Beirut, Lebanon. Electronic address: zn17@aub.edu.lb.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Nahas
mesh_terms: D000368:Aged; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology; D003863:Depression / Q000150:complications / Q000473:pathology; D004565:Electroconvulsive Therapy / Q000379:methods*; D004569:Electroencephalography / Q000379:methods; D006801:Humans; D008297:Male; D010477:Perfusion; D017397:Prefrontal Cortex / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D012640:Seizures / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D015899:Tomography, Emission-Computed, Single-Photon
keywords: Brain stimulation; Depression; ECT; Electroconvulsive therapy; FEAST; Focally electrically administered seizure therapy; SPECT