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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

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Beyond the seizure: postictal intracranial hemodynamics in electroconvulsive therapy

BEYOND THE SEIZURE: POSTICTAL INTRACRANIAL HEMODYNAMICS IN ELECTROCONVULSIVE THERAPY

Blood flow velocities in both intracranial and extracranial arteries increase significantly but transiently after ECT, return to normal within 60 minutes, and are accompanied by an unchanged Lindegaard ratio.

Although the cardiovascular response to electroconvulsive therapy (ECT) is well established, short-term postictal cerebral blood flow dynamics remain poorly understood. The aim was therefore to assess middle cerebral artery (MCA) and internal carotid artery (ICA) blood flow before ECT, immediately afterward, and 60 minutes afterward. In 12 patients with treatment-resistant depression (4 men, 8 women; mean age 49.08±14.65 years; F33.2 n=11, F33.3 n=1), peak systolic velocity (PSV), end-diastolic velocity (EDV), and the Lindegaard ratio (LR), calculated using time-averaged maximum velocity (TaMAX), were measured by duplex sonography across 5 consecutive ECT sessions; mean arterial pressure (MAP) was also recorded. The analysis used linear mixed-effects models with random intercepts for patient and session, together with Type III analysis of variance (ANOVA) for fixed effects; p-values were Bonferroni-adjusted across ten flow parameters. The effect of measurement time was significant for left MCA PSV (F=15.41, p<0.001; partial eta squared 0.16), left ICA PSV (F=16.58, p<0.001; 0.22), left ICA EDV (F=10.53, p<0.001; 0.15), right MCA EDV (F=7.64, p<0.001), and right ICA PSV (F=8.92, p<0.001; Bonferroni-adjusted p=0.002). In contrast, left LR (F=0.36; p=0.700) and right LR (F=0.14; p=0.874) remained unchanged. Although MAP increased markedly, its association with flow parameters was limited and remained significant after Bonferroni correction only for right LR (p=0.047). The authors report that ECT-related postictal increases in velocity normalized within 60 minutes, indicating a short-lived, reversible, systemic response rather than an isolated intracranial change. They emphasize that these findings contribute to the cardiovascular safety profile of ECT and that the underlying mechanisms and their relationship to treatment response should be investigated in follow-up studies.

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