Regional Cerebral Blood Flow Changes Associated With Focal Electrically Administered Seizure Therapy (FEAST)

• Main Authors: George Chahine, Baron Short, Ken Spicer, Matthew Schmidt, Carol Burns, Mia Atoui, Mark S. George, Harold A. Sackeim, Ziad Nahas
• Format: Article
• Language: English
• Published: Elsevier 2014-05-01
• Series: Brain Stimulation
• Subjects: ECT; Electroconvulsive therapy; FEAST; Focally electrically administered seizure therapy; SPECT; Depression
• Online Access: http://www.sciencedirect.com/science/article/pii/S1935861X14001090

Introduction: Use of electroconvulsive therapy (ECT) is limited by cognitive disturbance. Focal electrically-administered seizure therapy (FEAST) is designed to initiate focal seizures in the prefrontal cortex. To date, no studies have documented the effects of FEAST on regional cerebral blood flow (rCBF). Methods: A 72 year old depressed man underwent three single photon emission computed tomography (SPECT) scans to capture the onset and resolution of seizures triggered with right unilateral FEAST. We used Bioimage Suite for within-subject statistical analyses of perfusion differences ictally and post-ictally compared with the baseline scan. Results: Early ictal increases in regional cerebral blood flow (rCBF) were limited to the right prefrontal cortex. Post-ictally, perfusion was reduced in bilateral frontal and occipital cortices and increased in left motor and precuneus cortex. Conclusion: FEAST appears to triggers focal onsets of seizure activity in the right prefrontal cortex with subsequent generalization. Future studies are needed on a larger sample.