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A feasibility study of a new method for electrically producing seizures in man: Focal electrically administered seizure therapy [FEAST]

Show simple item record Nahas Z. Short B. Burns C. Archer M. Schmidt M. Prudic J. Nobler M.S. Devanand D.P. Fitzsimons L. Lisanby S.H. Payne N. Perera T. George M.S. Sackeim H.A.
dc.contributor.editor May-2013 2017-10-05T16:04:44Z 2017-10-05T16:04:44Z 2013
dc.identifier 10.1016/j.brs.2013.03.004
dc.description.abstract Background: Electroconvulsive therapy (ECT) remains the most effective acute treatment for severe major depression, but with significant risk of adverse cognitive effects. Unidirectional electrical stimulation with a novel electrode placement and geometry (Focal Electrically Administered Seizure Therapy (FEAST)) has been proposed as a means to initiate seizures in prefrontal cortex prior to secondary generalization. As such, it may have fewer cognitive side effects than traditional ECT. We report on its first human clinical application. Method: Seventeen unmedicated depressed adults (5 men; 3 bipolar disorder; age 53 ± 16 years) were recruited after being referred for ECT. Open-label FEAST was administered with a modified spECTrum 5000Q device and a traditional ECT dosing regimen until patients clinically responded. Clinical and cognitive assessments were obtained at baseline, and end of course. Time to orientation recovery, a predictor of long-term amnestic effects, was assessed at each treatment. Nonresponders to FEAST were transitioned to conventional ECT. Results: One patient withdrew from the study after a single titration session. After the course of FEAST (median 10 sessions), there was a 46.1 ± 35.5percent improvement in Hamilton Rating Scale for Depression (HRSD24) scores compared to baseline (33.1 ± 6.8, 16.8 ± 10.9; P andlt; 0.0001). Eight of 16 patients met response criteria (50percent decrease in HRSD24) and 5-16 met remission criteria (HRSD24 ≤ 10). Patients achieved full re-orientation (4 of 5 items) in 5.5 ± 6.4 min (median = 3.6), timed from when their eyes first opened after treatment. Conclusion: In this feasibility study, FEAST produced clinically meaningful antidepressant improvement, with relatively short time to reorientation. Our preliminary work first in primates and now depressed adults demonstrates that FEAST is feasible, safe, well-tolerated and, if efficacy can be optimized, has potential to replace traditional ECT. © 2013 Elsevier Inc. All rights reserved.
dc.format.extent Pages: (403-408)
dc.language English
dc.publisher NEW YORK
dc.relation.ispartof Publication Name: Brain Stimulation; Publication Year: 2013; Volume: 6; no. 3; Pages: (403-408);
dc.source Scopus
dc.title A feasibility study of a new method for electrically producing seizures in man: Focal electrically administered seizure therapy [FEAST]
dc.type Article
dc.contributor.affiliation Nahas, Z., Department of Psychiatry, American University of Beirut, Beirut, Lebanon, Medical University of South Carolina, SC, United States
dc.contributor.affiliation Short, B., Medical University of South Carolina, SC, United States
dc.contributor.affiliation Burns, C., Medical University of South Carolina, SC, United States
dc.contributor.affiliation Archer, M., Medical University of South Carolina, SC, United States
dc.contributor.affiliation Schmidt, M., Medical University of South Carolina, SC, United States
dc.contributor.affiliation Prudic, J., Department of Psychiatry, Columbia University, NY, United States
dc.contributor.affiliation Nobler, M.S., Department of Psychiatry and Behavioral Sciences, New York Medical College, NY, United States
dc.contributor.affiliation Devanand, D.P., Department of Psychiatry, Columbia University, NY, United States
dc.contributor.affiliation Fitzsimons, L., Department of Psychiatry, Columbia University, NY, United States
dc.contributor.affiliation Lisanby, S.H., Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, NC, United States
dc.contributor.affiliation Payne, N., New York University, NY, United States
dc.contributor.affiliation Perera, T., Department of Psychiatry, Columbia University, NY, United States
dc.contributor.affiliation George, M.S., Medical University of South Carolina, SC, United States, Ralph H. Johnson VA Medical Center, Charleston, SC, United States
dc.contributor.affiliation Sackeim, H.A., Department of Psychiatry, Columbia University, NY, United States
dc.contributor.authorAddress Nahas, Z.; American University of Beirut, P.O. Box, Beirut, Lebanon; email:
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Psychiatry;
dc.contributor.authorDepartment Psychiatry
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials Nahas, Z
dc.contributor.authorInitials Short, B
dc.contributor.authorInitials Burns, C
dc.contributor.authorInitials Archer, M
dc.contributor.authorInitials Schmidt, M
dc.contributor.authorInitials Prudic, J
dc.contributor.authorInitials Nobler, MS
dc.contributor.authorInitials Devanand, DP
dc.contributor.authorInitials Fitzsimons, L
dc.contributor.authorInitials Lisanby, SH
dc.contributor.authorInitials Payne, N
dc.contributor.authorInitials Perera, T
dc.contributor.authorInitials George, MS
dc.contributor.authorInitials Sackeim, HA
dc.contributor.authorReprintAddress Nahas, Z (reprint author), Amer Univ Beirut, Beirut, Lebanon.
dc.contributor.authorUniversity American University of Beirut Medical Center
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dc.description.citedCount 7
dc.description.citedTotWOSCount 8
dc.description.citedWOSCount 8
dc.format.extentCount 6
dc.identifier.pubmedID 23518262
dc.identifier.scopusID 84877790690
dc.publisher.address 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
dc.relation.ispartOfISOAbbr Brain Stimul.
dc.relation.ispartOfIssue 3
dc.relation.ispartofPubTitle Brain Stimulation
dc.relation.ispartofPubTitleAbbr Brain Stimul.
dc.relation.ispartOfVolume 6
dc.source.ID WOS:000325671700026
dc.type.publication Journal
dc.subject.otherAuthKeyword Depression
dc.subject.otherAuthKeyword ECT
dc.subject.otherAuthKeyword FEAST
dc.subject.otherAuthKeyword Seizure
dc.subject.otherIndex adult
dc.subject.otherIndex aged
dc.subject.otherIndex article
dc.subject.otherIndex bipolar disorder
dc.subject.otherIndex burn
dc.subject.otherIndex clinical article
dc.subject.otherIndex clinical assessment
dc.subject.otherIndex cognition
dc.subject.otherIndex depression
dc.subject.otherIndex electroconvulsive therapy
dc.subject.otherIndex electrode
dc.subject.otherIndex electroencephalogram
dc.subject.otherIndex feasibility study
dc.subject.otherIndex female
dc.subject.otherIndex Hamilton scale
dc.subject.otherIndex human
dc.subject.otherIndex male
dc.subject.otherIndex priority journal
dc.subject.otherIndex seizure
dc.subject.otherIndex treatment outcome
dc.subject.otherIndex treatment response
dc.subject.otherIndex Aged
dc.subject.otherIndex Electroconvulsive Therapy
dc.subject.otherIndex Electrodes
dc.subject.otherIndex Feasibility Studies
dc.subject.otherIndex Female
dc.subject.otherIndex Humans
dc.subject.otherIndex Male
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Neuropsychological Tests
dc.subject.otherIndex Orientation
dc.subject.otherIndex Seizures
dc.subject.otherIndex Treatment Outcome
dc.subject.otherIndex Primates
dc.subject.otherKeywordPlus ELECTROCONVULSIVE-THERAPY
dc.subject.otherKeywordPlus ELECTRODE PLACEMENT
dc.subject.otherKeywordPlus PERIPHERAL-NERVE
dc.subject.otherKeywordPlus MOTOR CORTEX
dc.subject.otherKeywordPlus STIMULUS-INTENSITY
dc.subject.otherKeywordPlus COIL STIMULATION
dc.subject.otherKeywordPlus ECT
dc.subject.otherKeywordPlus EFFICACY
dc.subject.otherKeywordPlus MECHANISMS
dc.subject.otherWOS Clinical Neurology
dc.subject.otherWOS Neurosciences

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