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New ECT method could reduce memory problems
Contact: Heather Woolwine
CHARLESTON – A new study published in Brain Stimulation reports the initial clinical results of a novel form of precise ECT called FEAST (Focal Electrically Administered Seizure Therapy). This new form of ECT uses pulsed direct current stimulation, with the bulk of the electrical charge delivered directly under one electrode which is placed about two inches above the right eye. Traditional ECT uses alternating current, which flows in both directions and is thus harder to direct and target. Electroconvulsive therapy (ECT) remains the most effective acute treatment for severe major depression. However even with newer forms of ECT, there remains a significant risk of adverse cognitive effects, particularly memory problems.
“In this feasibility study, we found that targeted ECT produced clinically meaningful improvement in depression for these patients,” said Ziad Nahas, M.D., first author of the research conducted jointly at the Medical University of South Carolina and Columbia University in New York. Nahas is now professor and department chair of the Department of Psychiatry, American University of Beirut at America University in Beirut, Lebanon. “Importantly, the time it took for patients to be fully reoriented after the treatment was just five minutes from when they first opened their eyes. This orientation time traditionally predicts the longer-term cognitive side effects. This is much quicker than any other form of ECT, where the reorientation time is much greater, sometimes up to or exceeding an hour.”
This clinical trial in 17 depressed adults builds on earlier design work and animal testing done at Columbia University. Overall, the group had their depression symptoms almost reduced by half, after an average of 10 sessions during four weeks. Eight patients had at least a 50% reduction in their symptoms, and five were largely symptom free. This was the first human use of FEAST, and the group is continuing to refine the method and test how it works using advanced brain imaging.
Harold Sackeim, M.D., professor of Psychiatry and Radiology at Columbia University and the early developer of the technique, said, “These initial encouraging results suggest that one can perfect and refine ECT with a more focal delivery system like FEAST. These are exciting confirmatory data in depressed patients building on what we found in earlier work.”
The article is “A Feasibility Study of a New Method for Electrically Producing Seizures in Man: Focal Electrically Administered Seizure Therapy [FEAST]” by Ziad Nahas, Baron Short, Carol Burns, Melanie Archer, Matthew Schmidt, Joan Prudic, Mitchell S. Nobler, D.P. Devanand, Linda Fitzsimons, Sarah H. Lisanby, Nancy Payne, Tarique Perera, Mark S. George, and Harold A. Sackeim (DOI: 10.1016/j.brs.2013.03.004). The article appears in Brain Stimulation, Volume 6, Issue 3 (May-June, 2013), published by Elsevier.
The research was funded through an NIH grant for the initial development and human clinical work. MECTA corporation collaborated by supplying equipment.
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