title: Seizure Adequacy Markers and the Prediction of Electroconvulsive Therapy Response.
abstract: OBJECTIVE
  Electroconvulsive therapy (ECT) is the most effective therapy for patients with treatment-resistant depression; however, some patients do not respond or relapse in a short time. Electroconvulsive therapy stimulus parameters may be related to the outcome. We carried out a retrospective study review to investigate various ECT parameters in relation to the outcome, clinical variables, and pharmacological treatments. Our aim was to understand which factors could be considered putative seizure quality markers and which are relevant to clinical practice.
  
  
  METHODS
  Two physicians evaluated the seizure length, the postictal suppression index, the wave amplitude, tachycardia, and hemispheric brain wave synchronicity in a double-blind manner for 45 treatment-resistant depression patients receiving ECT.
  
  
  RESULTS
  The analysis showed a significant association between the outcome and the ECT seizure quality measured by the parameters (P = 9.9 × 10). Among patients with poor-quality seizures, 61.5% relapsed after approximately 1 month from the last ECT session. Particularly, there was an association between higher symptomatology decrease and higher quality of hemispheric brain wave synchronicity (P = 5.0 × 10), as well as a higher wave amplitude (P = 0.01).
  
  
  CONCLUSIONS
  Our results confirm that ECT seizure quality was strongly correlated with the decrease of depressive symptomatology.
authors.affiliation: From the *Department of Molecular and Translational Medicine, Biology and Genetic Division, University of Brescia, Brescia; †Psychiatric Hospital "Villa Santa Chiara"; and ‡Department of Philosophy, Education, Psychology University of Verona, Verona; §Genetic Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia; and ∥Department of Psychiatry, Central Hospital of Bolzano, Bolzano, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Minelli
authors.forename: Maria
authors.initials: M
authors.lastname: Abate
authors.forename: Elisa
authors.initials: E
authors.lastname: Zampieri
authors.forename: Giulio
authors.initials: G
authors.lastname: Gainelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Trabucchi
authors.forename: Matilde
authors.initials: M
authors.lastname: Segala
authors.forename: Riccardo
authors.initials: R
authors.lastname: Sartori
authors.forename: Massimo
authors.initials: M
authors.lastname: Gennarelli
authors.forename: Andreas
authors.initials: A
authors.lastname: Conca
authors.forename: Marco
authors.initials: M
authors.lastname: Bortolomasi
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D061218:Depressive Disorder, Treatment-Resistant / Q000523:psychology / Q000628:therapy*; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy / Q000379:methods*; D004569:Electroencephalography; D058407:Electroencephalography Phase Synchronization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012640:Seizures / Q000503:physiopathology*; D012959:Socioeconomic Factors; D013610:Tachycardia / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents