Washington University School of Medicine
Electroconvulsive therapy (ECT) alleviates treatment-resistant depression (TRD) through repeated generalized seizures. The goal of this study is to evaluate how ECT impacts sleep-wake regulation and efficiency of information transfer in functional networks in different states of arousal.
Graph-based network analyses of electroencephalographic (EEG) signals allow characterization of functional networks. The robustness of local networks to disruption is quantified as local efficiency (Elocal), while network integration is quantified as global information transfer (Eglobal). Aim 1: Assess relationships between sleep slow-wave activity (SWA) and awake Elocal over the course of ECT. Aim 2: Quantify relationships between depression severity and awake Elocal over the course of ECT.
Inclusion Criteria: * Referral for initial ECT index course for Treatment-Resistant Depression (TRD), unipolar major depressive disorder or bipolar depression. Historic failure of response or remission to at least two antidepressant medications of sufficient dose and duration will be used for TRD diagnostic. Exclusion Criteria: * Diagnoses of schizophrenia or schizoaffective disorders. * Subjects who are unable to tolerate the Dreem device for sleep recordings will be excluded from the study.
High-density EEG will be acquired during resting wakefulness before each ECT session.
Overnight sleep EEG will be recorded one day before each ECT session using the DREEM device. The DREEM device allows continuous recording of multichannel EEG.
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