Disruptions of Brain Networks and Sleep by Electroconvulsive Therapy

Washington University School of Medicine50 enrolled

Overview

Electroconvulsive therapy (ECT) alleviates treatment-resistant depression (TRD) through repeated generalized seizures. The goal of this study is to evaluate how ECT impacts sleep-wake regulation and efficiency of information transfer in functional networks in different states of arousal.

Graph-based network analyses of electroencephalographic (EEG) signals allow characterization of functional networks. The robustness of local networks to disruption is quantified as local efficiency (Elocal), while network integration is quantified as global information transfer (Eglobal). Aim 1: Assess relationships between sleep slow-wave activity (SWA) and awake Elocal over the course of ECT. Aim 2: Quantify relationships between depression severity and awake Elocal over the course of ECT.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Treatment Resistant Depression

Interventions

Electroencephalography (EEG)DIAGNOSTIC_TEST

High-density EEG will be acquired during resting wakefulness before each ECT session.

Quantitative Measurements of Sleep MicrostructureDIAGNOSTIC_TEST

Overnight sleep EEG will be recorded one day before each ECT session using the DREEM device. The DREEM device allows continuous recording of multichannel EEG.

Eligibility

Sex: ALLMin age: 21 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Referral for initial ECT index course for Treatment-Resistant Depression (TRD), unipolar major depressive disorder or bipolar depression. Historic failure of response or remission to at least two antidepressant medications of sufficient dose and duration will be used for TRD diagnostic. Exclusion Criteria: * Diagnoses of schizophrenia or schizoaffective disorders. * Subjects who are unable to tolerate the Dreem device for sleep recordings will be excluded from the study.

Locations (1)

Washington University School of Medicine/Barnes-Jewish Hospital

St Louis, Missouri, United States

RECRUITING

Outcomes

Primary Outcomes

Slow wave activity (SWA) during non-rapid eye movement sleep (NREM) stage N2/N3

Total power of EEG slow waves per minute present during N2/N3 sleep

Time frame: Up to 4 weeks during patients ECT treatment course

Graph-based neural connectivity measure of local efficiency of information transfer (Elocal) during wakefulness

Elocal will be calculated as the average inverse shortest path length among neighbors of a node within the network. Nodes will be constructed based on 5-minute recordings of eyes closed wakefulness theta band (4-8 Hz) EEG.

Time frame: Up to 4 weeks during patients ECT treatment course

Graph-based neural connectivity measure of global information transfer (Eglobal) during ECT-induced seizure

Eglobal will be calculated as the average inverse shortest path length between node pairs in the networks. Nodes will be constructed based on ECT-induced seizure EEG data within the alpha band (8-13 Hz).

Time frame: Up to 4 weeks during patients ECT treatment course

Central Contacts

Robby Greenspan

CONTACT

314-273-6129 greenspan@wustl.edu

MohammadMehdi Kafashan

CONTACT

314-273-8848 kafashan@wustl.edu

Data from ClinicalTrials.gov

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