ArticleEuropean psychiatry : the journal of the Association of European Psychiatrists2024
Restoration of postictal cortical activity after electroconvulsive therapy relates to recovery of orientation in person, place, and time.
Article in European psychiatry : the journal of the Association of European Psychiatrists, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Exploring postictal recovery with acetaminophen or nimodipine: A randomized-controlled crossover trial.Annals of clinical and translational neurology · 2024Trial
- Corticothalamic dynamics during postictal recovery of self-orientation after electroconvulsive therapy.Brain communications · 2026Article
- The postictal systems window hypothesis of electroconvulsive therapy in major depression.Frontiers in psychiatry · 2026Article
- Comparative efficacy and cognitive safety of bifrontal versus bitemporal electroconvulsive therapy in adolescents with major depressive disorder: a retrospective cohort study.Frontiers in psychiatry · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost patients show temporary impairments in clinical orientation after electroconvulsive therapy (ECT)-induced seizures. It is unclear how postictal reorientation relates to electroencephalography (EEG) restoration. This relationship may provide additional measures to quantify postictal recovery and shed light on neurophysiological aspects of reorientation after ECT.
methodsWe analyzed prospectively collected clinical and continuous ictal and postictal EEG data from ECT patients. Postictal EEG restoration up to 1 h was estimated by the evolution of the normalized alpha-delta ratio (ADR). Times to reorientation in the cognitive domains of person, place, and time were assessed postictally. In each cognitive domain, a linear mixed model was fitted to investigate the relationships between time to reorientation and postictal EEG restoration.
resultsIn total, 272 pairs of ictal-postictal EEG and reorientation times of 32 patients were included. In all domains, longer time to reorientation was associated with slower postictal EEG recovery. Longer seizure duration and postictal administration of midazolam were related to longer time to reorientation in all domains. At 1-hour post-seizure, most patients were clinically reoriented, while their EEG had only partly restored.
conclusionsWe show a relationship between postictal EEG restoration and clinical reorientation after ECT-induced seizures. EEG was more sensitive than reorientation time in all domains to detect postictal recovery beyond 1-hour post-seizure. Our findings indicate that clinical reorientation probably depends on gradual cortical synaptic recovery, with longer seizure duration leading to longer postsynaptic suppression after ECT seizures.
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