TY - JOUR
T1 - Seizure duration predicts postictal electroencephalographic recovery after electroconvulsive therapy-induced seizures
AU - C. M. Pottkämper, Julia
AU - P. A. J. Verdijk, Joey
AU - Stuiver, Sven
AU - Aalbregt, Eva
AU - Schmettow, Martin
AU - Hofmeijer, Jeannette
AU - van Waarde, Jeroen A.
AU - J. A. M. van Putten, Michel
N1 - Funding Information: This works was supported by the Dutch National Epilepsy Fund [EpilepsieNL; grant number WAR 19-02]. Publisher Copyright: © 2023 International Federation of Clinical Neurophysiology
PY - 2023/4/1
Y1 - 2023/4/1
N2 - Objective: We aim to provide a quantitative description of the relation between seizure duration and the postictal state using features extracted from the postictal electroencephalogram (EEG). Methods: Thirty patients with major depressive disorder treated with electroconvulsive therapy (ECT) were studied with continuous EEG before, during, and after ECT-induced seizures. EEG recovery was quantified as the spectral difference between postictal and baseline EEG using the temporal brain symmetry index (BSI). The postictal temporal EEG evolution was modeled with a single exponential. The parameters of the model, including the time constant τ, describe the change and speed of postictal EEG recovery. The change from baseline EEG at t = 60 minutes post-seizure (ΔBSI) was calculated from the exponential fit. Postictal clinical reorientation time (ROT) was clinically established. A multivariate generalized multi-level Bayesian model was estimated with seizure duration and ROT as predictors of τ and ΔBSI. Results: EEG features of 290 seizures and postictal states were used for analyses. The model faithfully described the dynamics of the postictal EEG in nearly all patients. Seizure duration was associated with the recovery time constant, τ, and ΔBSI. ROT was associated with τ, but not with ΔBSI. Conclusions: Longer seizures are associated with slower postictal EEG recovery and more enduring EEG changes compared to baseline. Significance: Quantitative EEG allows objective assessment of the postictal state.
AB - Objective: We aim to provide a quantitative description of the relation between seizure duration and the postictal state using features extracted from the postictal electroencephalogram (EEG). Methods: Thirty patients with major depressive disorder treated with electroconvulsive therapy (ECT) were studied with continuous EEG before, during, and after ECT-induced seizures. EEG recovery was quantified as the spectral difference between postictal and baseline EEG using the temporal brain symmetry index (BSI). The postictal temporal EEG evolution was modeled with a single exponential. The parameters of the model, including the time constant τ, describe the change and speed of postictal EEG recovery. The change from baseline EEG at t = 60 minutes post-seizure (ΔBSI) was calculated from the exponential fit. Postictal clinical reorientation time (ROT) was clinically established. A multivariate generalized multi-level Bayesian model was estimated with seizure duration and ROT as predictors of τ and ΔBSI. Results: EEG features of 290 seizures and postictal states were used for analyses. The model faithfully described the dynamics of the postictal EEG in nearly all patients. Seizure duration was associated with the recovery time constant, τ, and ΔBSI. ROT was associated with τ, but not with ΔBSI. Conclusions: Longer seizures are associated with slower postictal EEG recovery and more enduring EEG changes compared to baseline. Significance: Quantitative EEG allows objective assessment of the postictal state.
KW - Clinical reorientation time
KW - Depression
KW - Electroconvulsive therapy
KW - Postictal EEG recovery
KW - Temporal brain symmetry index
UR - http://www.scopus.com/inward/record.url?scp=85147666175&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.clinph.2023.01.008
DO - https://doi.org/10.1016/j.clinph.2023.01.008
M3 - Article
C2 - 36773503
SN - 1388-2457
VL - 148
SP - 1
EP - 8
JO - Clinical neurophysiology
JF - Clinical neurophysiology
ER -