Optic Nerve Sheath Ultrasound During Electroconvulsive Therapy

NCT ID: NCT06607679

Last Updated: 2025-02-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

39 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-06-03

Study Completion Date

2022-11-23

Brief Summary

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Electroconvulsive therapy (ECT) is an effective method that has been used for many years in the treatment of psychiatric disorders and is currently administered under general anesthesia. This study evaluated the effect of ECT on intracranial pressure by measuring the optic nerve sheath diameter (ONSD) using ultrasonography. The primary aim was to determine how ONSD values measured during the postictal period change compared to baseline values. Secondary objectives included identifying factors related to the participants and the ECT procedure that affect ONSD.

Detailed Description

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Electroconvulsive therapy (ECT) is a treatment method that has been used effectively for many years in the treatment of psychiatric disorders. Typical uses of ECT include depression, schizophrenia, bipolar disorder, cases resistant to standard therapies, individuals at risk of suicide, and patients exhibiting symptoms of catatonia. The safety of ECT remains a highly debated issue. It is commonly believed that ECT should be avoided in cases of tumors or other space-occupying lesions due to concerns that the therapys stimulus or induced seizure could lead to increased intracranial pressure. The American Psychiatric Association Task Force Report recommends a detailed evaluation of the risk-benefit ratio and measures to minimize the risks associated with the treatment. Measurement of the optic nerve sheath diameter (ONSD) with ultrasound is a direct, noninvasive, and rapid technique for assessing raised ICP. Comparisons between ocular sonography and magnetic resonance imaging (MRI) have shown an acceptable correlation and reliability. In this study, the effects of ECT on intracranial pressure were evaluated by measuring the optic nerve sheath diameter (ONSD) using ultrasonography. The primary aim was to determine the change in ONSD value during the postictal period compared to baseline. Secondary objectives include identifying participants and ECT procedure-related factors affecting ONSD.

Conditions

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Intracranial Pressure Change Hypertension Electroconvulsive Therapy Treated Patients

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients Receiving ECT

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* 18 years and older
* ASA 1,2,3
* Participants with various psychiatric problems requiring ECT

Exclusion Criteria

* Intracranial mass, edema, or bleeding observed on MRI scan
* previous eye surgery
* severe cataracts
* glaucoma
* optic atrophy
* other severe sight impairment
* traumatic brain injury, space-occupying, and inflammatory lesions
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cukurova University Medical Faculty Hospital

UNKNOWN

Sponsor Role collaborator

İrem AKSOY

OTHER

Sponsor Role lead

Responsible Party

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İrem AKSOY

Consultant Anesthesiologist

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Demet Laflı Tunay, Associate Professor

Role: PRINCIPAL_INVESTIGATOR

Department of Anesthesiology and Reanimation, Çukurova University

Locations

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Cukurova University Faculty of Medicine Hospital

Adana, Sariçam, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Chawla N. Anesthesia for Electroconvulsive Therapy. Anesthesiol Clin. 2020 Mar;38(1):183-195. doi: 10.1016/j.anclin.2019.10.007. Epub 2020 Jan 3.

Reference Type BACKGROUND
PMID: 32008651 (View on PubMed)

Singh SK, Bhatia K. Ultrasonographic Optic Nerve Sheath Diameter as a Surrogate Measure of Raised Intracranial Pressure in Severe Pregnancy-induced Hypertension Patients. Anesth Essays Res. 2018 Jan-Mar;12(1):42-46. doi: 10.4103/aer.AER_218_17.

Reference Type BACKGROUND
PMID: 29628552 (View on PubMed)

Derikx RL, van Waarde JA, Verwey B, van der Mast RC. Effects on intracranial pressure of electroconvulsive therapy. J ECT. 2012 Jun;28(2):e23-4. doi: 10.1097/YCT.0b013e31824d9b69.

Reference Type BACKGROUND
PMID: 22622301 (View on PubMed)

Czosnyka M, Pickard JD. Monitoring and interpretation of intracranial pressure. J Neurol Neurosurg Psychiatry. 2004 Jun;75(6):813-21. doi: 10.1136/jnnp.2003.033126.

Reference Type BACKGROUND
PMID: 15145991 (View on PubMed)

Bouckaert F, Sienaert P, Obbels J, Dols A, Vandenbulcke M, Stek M, Bolwig T. ECT: its brain enabling effects: a review of electroconvulsive therapy-induced structural brain plasticity. J ECT. 2014 Jun;30(2):143-51. doi: 10.1097/YCT.0000000000000129.

Reference Type BACKGROUND
PMID: 24810772 (View on PubMed)

Andrade C, Bolwig TG. Electroconvulsive therapy, hypertensive surge, blood-brain barrier breach, and amnesia: exploring the evidence for a connection. J ECT. 2014 Jun;30(2):160-4. doi: 10.1097/YCT.0000000000000133.

Reference Type BACKGROUND
PMID: 24800688 (View on PubMed)

Perera TD, Luber B, Nobler MS, Prudic J, Anderson C, Sackeim HA. Seizure expression during electroconvulsive therapy: relationships with clinical outcome and cognitive side effects. Neuropsychopharmacology. 2004 Apr;29(4):813-25. doi: 10.1038/sj.npp.1300377.

Reference Type BACKGROUND
PMID: 14735129 (View on PubMed)

Baghai TC, Moller HJ. Electroconvulsive therapy and its different indications. Dialogues Clin Neurosci. 2008;10(1):105-17. doi: 10.31887/DCNS.2008.10.1/tcbaghai.

Reference Type BACKGROUND
PMID: 18472488 (View on PubMed)

Dubourg J, Javouhey E, Geeraerts T, Messerer M, Kassai B. Ultrasonography of optic nerve sheath diameter for detection of raised intracranial pressure: a systematic review and meta-analysis. Intensive Care Med. 2011 Jul;37(7):1059-68. doi: 10.1007/s00134-011-2224-2. Epub 2011 Apr 20.

Reference Type BACKGROUND
PMID: 21505900 (View on PubMed)

Andrade C, Arumugham SS, Thirthalli J. Adverse Effects of Electroconvulsive Therapy. Psychiatr Clin North Am. 2016 Sep;39(3):513-30. doi: 10.1016/j.psc.2016.04.004. Epub 2016 Jun 25.

Reference Type BACKGROUND
PMID: 27514303 (View on PubMed)

Other Identifiers

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2022-05-03-123/26

Identifier Type: -

Identifier Source: org_study_id

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