All procedures involving human participants have been performed in compliance with the institutional, national, and international guidelines for human welfare and have been reviewed by the local institutional review board.1. Electroconvulsive Therapy Procedure1. Conduct electroconvulsive therapy (ECT) via bitemporal electrode stimulation using an ECT instrument. Set the initial electrical stimulus dose (%) at half the value of each individual&#8217;s age. NOTE: Maximum stimulus dose is 100%. The electrical stimulation time is about 7-8 s.2. Immediately after electrical stimulation, hold the automated infrared pupillometer over one of the patient&#8217;s eyes. At this time, if the patient closes their eyes, keep the patient&#8217;s eyelid open. Press the device button, and measure maximum (initial) resting pupil size or minimum pupil size after stimulation.3. Perform controlled ventilation using a face mask with 100% oxygen until the patient begins breathing spontaneously.4. Using an electroencephalogram (EEG), measure ictal regularity, seizure time, and greater postictal suppression by the psychiatrist (Figure 1 and Figure 2).

<table><tbody><tr><td>Npi-100/automated infrared pupillometer</td><td>NeurOptics</td><td> </td><td> </td></tr><tr><td>Electroencephalogram (EEG)</td><td>Somatics Inc.</td><td>ECEF-4</td><td> </td></tr><tr><td>Npi-200/automated infrared pupillometer</td><td>NeurOptics</td><td> </td><td> </td></tr></tbody></table>

performing electroconvulsive therapy and assessing seizure efficacy via pupillary response

Source: <a href='https://app.jove.com/v/59488/pupillary-response-as-assessment-of-effective-seizure-induction-by-electroconvulsive-therapy'>Shirozu, K., et al. Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy. J. Vis. Exp. (2019)</a>This video demonstrates the procedure for performing electroconvulsive therapy in a human patient, highlighting the stimulation process and assessing seizure activity through pupillary response.

<figure class="image image-style-align-center image_resized" style="display:table;margin-left:auto;margin-right:auto;width:75%;"><img style="aspect-ratio:714/523;" src="https://cloudfront.jove.com/files/ftp_upload/23898/23898_Figure1_editor_23898.jpg" alt="EEG seizure analysis; diagram displaying postictal suppression index and seizure criteria evaluation." data-altupdatedat="1762173717000" data-alt="23898_Figure1.jpg" /></figure>Figure 1. Electroencephalogram (EEG) results during a typical seizure.<figure class="image image-style-align-...

Performing Electroconvulsive Therapy and Assessing Seizure Efficacy via Pupillary Response

Source: Shirozu, K., et al. Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy. J. Vis. Exp. (2019)This video ...

Begin with an anesthetized patient diagnosed with depression, fitted with adhesive pads on the temples for electroconvulsive stimulation.In the brain, the electrical current activates neuronal sodium channels, causing rapid sodium influx.This leads to neuronal depolarization and triggers neuronal firing.Excessive synchronized firing releases excitatory neurotransmitters, resulting in persistent neuronal activation and inducing a seizure.Seizure activity enhances the release of neurotrophic factors, promoting neurogenesis and improving neuronal communication, which helps alleviate depression-like symptoms.Additionally, seizure activity stimulates the sympathetic nervous system, causing pupil dilation.Immediately after seizure cessation, position an automated infrared pupillometer over one eye to measure the pupillary response.Activate the device to emit white light to constrict the pupil.In the patient, the absence of pupil constriction after light exposure indicates prolonged sympathetic activation and adequate seizure induction.After anesthetizing the patient, begin the electroconvulsive therapy or ECT procedure by using an ECT instrument set at an initial electrical stimulus dose percentage at half the value of the patient's age.Then, immediately after electrical stimulation, hold the automated infrared pupillometer over one of the patient's eyes. After the patient's eyes are opened by an examiner, press the device button and measure maximum resting pupil size or minimum pupil size after stimulation. Next, perform controlled ventilation using a face mask with 100%oxygen until the patient begins breathing spontaneously.Finally, using EEG, measure ictal regularity, seizure time, and greater post-ictal suppression.

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1.2K Views. Begin with an anesthetized patient diagnosed with depression, fitted with adhesive pads on the temples for electroconvulsive stimulation.In the brain, the electrical current activates neuronal sodium channels, causing rapid sodium influx.This leads to neuronal depolarization and triggers neuronal firing.Excessive synchronized firing releases excitatory neurotransmitters, resulting in persistent neuronal activation and inducing a seizure.Seizure activity enhances th...

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<figure class="image image-style-align-center image_resized" style="display:table;margin-left:auto;margin-right:auto;width:75%;"><img title="figure-results-1" style="aspect-ratio:714/523;" src="https://cloudfront.jove.com/files/ftp_upload/23898/23898_Figure1_editor_23898.jpg" alt="EEG seizure analysis; diagram displaying postictal suppression index and seizure criteria evaluation." data-altupdatedat="1762173717000" data-alt="23898_Figure1.jpg" /></figure>Figure 1. Electroencephalogram (EEG) results during a typical seizure.<figure class="image image-style-align-...

Performing Electroconvulsive Therapy and Assessing Seizure Efficacy via Pupillary Response

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