{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T16:51:47Z","timestamp":1786985507628,"version":"build-2736575974"},"reference-count":41,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T00:00:00Z","timestamp":1625097600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T00:00:00Z","timestamp":1625097600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T00:00:00Z","timestamp":1622246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["5R01MH112737-03"],"award-info":[{"award-number":["5R01MH112737-03"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH120991"],"award-info":[{"award-number":["R01MH120991"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R25MH094612"],"award-info":[{"award-number":["R25MH094612"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000051","name":"National Human Genome Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000051","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000874","name":"Brain and Behavior Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000874","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013113","name":"Stanley Center for Psychiatric Research, Broad Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013113","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013114","name":"Broad Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013114","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["brainstimjrnl.com","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Brain Stimulation"],"published-print":{"date-parts":[[2021,7]]},"DOI":"10.1016\/j.brs.2021.05.016","type":"journal-article","created":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T02:24:01Z","timestamp":1623378241000},"page":"941-946","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":40,"title":["Changes in seizure duration during acute course electroconvulsive therapy"],"prefix":"10.1016","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1606-3917","authenticated-orcid":false,"given":"James","family":"Luccarelli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Thomas H.","family":"McCoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Seiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael E.","family":"Henry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.brs.2021.05.016_bib1","doi-asserted-by":"crossref","first-page":"210","DOI":"10.9758\/cpn.2017.15.3.210","article-title":"How electroconvulsive therapy works?: understanding the neurobiological mechanisms","volume":"15","author":"Singh","year":"2017","journal-title":"Clin Psychopharmacol Neurosci"},{"key":"10.1016\/j.brs.2021.05.016_bib2","first-page":"5","article-title":"The anticonvulsant hypothesis of the mechanisms of action of ECT: current status","volume":"15","author":"Sackeim","year":"1999","journal-title":"J\u00a0ECT"},{"key":"10.1016\/j.brs.2021.05.016_bib3","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1056\/NEJM199303253281204","article-title":"Effects of stimulus intensity and electrode placement on the efficacy and cognitive effects of electroconvulsive therapy","volume":"328","author":"Sackeim","year":"1993","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.brs.2021.05.016_bib4","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/0006-3223(93)90089-V","article-title":"EEG manifestations during ECT: effects of electrode placement and stimulus intensity","volume":"34","author":"Nobler","year":"1993","journal-title":"Biol Psychiatr"},{"key":"10.1016\/j.brs.2021.05.016_bib5","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1176\/ajp.144.11.1449","article-title":"Effects of electrode placement on the efficacy of titrated, low-dose ECT","volume":"144","author":"Sackeim","year":"1987","journal-title":"Am J Psychiatr"},{"key":"10.1016\/j.brs.2021.05.016_bib6","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1017\/S0033291797005564","article-title":"Relationship of seizure duration to antidepressant efficacy in electroconvulsive therapy","volume":"27","author":"Kales","year":"1997","journal-title":"Psychol Med"},{"key":"10.1016\/j.brs.2021.05.016_bib7","series-title":"Practice of electroconvulsive therapy: recommendations for treatment, training, and privileging","author":"Committ","year":"2001"},{"key":"10.1016\/j.brs.2021.05.016_bib8","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1177\/0004867419839139","article-title":"Royal Australian and New Zealand College of Psychiatrists professional practice guidelines for the administration of electroconvulsive therapy","volume":"53","author":"Weiss","year":"2019","journal-title":"Aust N Z J Psychiatr"},{"key":"10.1016\/j.brs.2021.05.016_bib9","first-page":"1504","article-title":"Charge required to induce a seizure during initial dose titration using right unilateral brief pulse electroconvulsive therapy","volume":"13","author":"Luccarelli","year":"2020","journal-title":"Brain Stimul Basic Transl Clin Res Neuromodulation"},{"key":"10.1016\/j.brs.2021.05.016_bib10","first-page":"40","article-title":"Total charge required to induce a seizure in a retrospective cohort of patients undergoing dose titration of right unilateral ultrabrief pulse electroconvulsive therapy","volume":"37","author":"Luccarelli","year":"2021","journal-title":"J\u00a0ECT"},{"key":"10.1016\/j.brs.2021.05.016_bib11","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s00406-020-01202-2","article-title":"Rate of continuing acute course treatment using right unilateral ultrabrief pulse electroconvulsive therapy at a large academic medical center","volume":"271","author":"Luccarelli","year":"2021","journal-title":"Eur Arch Psychiatr Clin Neurosci"},{"key":"10.1016\/j.brs.2021.05.016_bib12","series-title":"Duration of treatment in electroconvulsive therapy among patients beginning with acute course right unilateral brief pulse stimuli","author":"Luccarelli","year":"2021"},{"key":"10.1016\/j.brs.2021.05.016_bib13","series-title":"Additive splines in statistics","first-page":"45","author":"Stone","year":"1985"},{"key":"10.1016\/j.brs.2021.05.016_bib14","first-page":"14","article-title":"Seizure length in electroconvulsive therapy as a function of age, sex, and treatment number:","volume":"23","author":"Rasimas","year":"2007","journal-title":"J\u00a0ECT"},{"key":"10.1016\/j.brs.2021.05.016_bib15","first-page":"243","article-title":"A\u00a0retrospective comparison of anesthetic agents in electroconvulsive therapy","volume":"22","author":"Swaim","year":"2006","journal-title":"J\u00a0ECT"},{"key":"10.1016\/j.brs.2021.05.016_bib16","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1017\/neu.2017.12","article-title":"Anaesthesia for electroconvulsive therapy \u2013 new tricks for old drugs: a systematic review","volume":"30","author":"Stripp","year":"2018","journal-title":"Acta Neuropsychiatr"},{"key":"10.1016\/j.brs.2021.05.016_bib17","first-page":"213","article-title":"Evaluation of etomidate for seizure duration in electroconvulsive therapy: a systematic review and meta-analysis","volume":"31","author":"Singh","year":"2015","journal-title":"J\u00a0ECT"},{"key":"10.1016\/j.brs.2021.05.016_bib18","first-page":"803","article-title":"Stimulus intensity, seizure threshold, and seizure duration","volume":"14","author":"Sackeim","year":"1991","journal-title":"Psychiatr Clin"},{"key":"10.1016\/j.brs.2021.05.016_bib19","first-page":"102","article-title":"Inverse relation between stimulus intensity and seizure duration: implications for ECT procedure","volume":"17","author":"Frey","year":"2001","journal-title":"J\u00a0ECT"},{"key":"10.1016\/j.brs.2021.05.016_bib20","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1046\/j.1440-1819.2002.01048.x","article-title":"Relationships between seizure duration and seizure threshold and stimulus dosage at electroconvulsive therapy: implications for electroconvulsive therapy practice","volume":"56","author":"Chung","year":"2002","journal-title":"Psychiatr Clin Neurosci"},{"key":"10.1016\/j.brs.2021.05.016_bib21","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1177\/104012371602800204","article-title":"Effect of electrical parameters on ECT convulsive threshold and duration","volume":"28","author":"Isenberg","year":"2016","journal-title":"Ann Clin Psychiatry Off J Am Acad Clin Psychiatr"},{"key":"10.1016\/j.brs.2021.05.016_bib22","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.2147\/NDT.S134503","article-title":"Effects of stimulus parameters on motor seizure duration in electroconvulsive therapy","volume":"13","author":"Joo","year":"2017","journal-title":"Neuropsychiatric Dis Treat"},{"key":"10.1016\/j.brs.2021.05.016_bib23","series-title":"Factors associated with seizure adequacy along the course of electroconvulsive therapy","author":"Tedeschi","year":"2020"},{"key":"10.1016\/j.brs.2021.05.016_bib24","first-page":"115","article-title":"Psychotropic medication effects on seizure threshold and seizure duration during electroconvulsive therapy stimulus titration","volume":"36","author":"Chiao","year":"2020","journal-title":"J\u00a0ECT"},{"key":"10.1016\/j.brs.2021.05.016_bib25","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1007\/s00406-016-0670-0","article-title":"Remifentanil in electroconvulsive therapy: a systematic review and meta-analysis of randomized controlled trials","volume":"266","author":"Takekita","year":"2016","journal-title":"Eur Arch Psychiatr Clin Neurosci"},{"key":"10.1016\/j.brs.2021.05.016_bib26","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/j.1600-0447.1956.tb04720.x","article-title":"Experiments in the prolongation of convulsions induced by electric shock treatment","volume":"31","author":"Holmberg","year":"1956","journal-title":"Acta Psychiatr Scand"},{"key":"10.1016\/j.brs.2021.05.016_bib27","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.genhosppsych.2017.09.003","article-title":"Hyperventilation and electroconvulsive therapy: a literature review","volume":"50","author":"G\u00f3mez-Arnau","year":"2018","journal-title":"Gen Hosp Psychiatr"},{"key":"10.1016\/j.brs.2021.05.016_bib28","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.jad.2009.07.011","article-title":"The difficult-to-treat electroconvulsive therapy patient \u2014 strategies for augmenting outcomes","volume":"124","author":"Loo","year":"2010","journal-title":"J\u00a0Affect Disord"},{"key":"10.1016\/j.brs.2021.05.016_bib29","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1016\/j.bja.2018.07.011","article-title":"Remifentanil as an adjunct to anaesthesia for electroconvulsive therapy fails to confer long-term benefits","volume":"121","author":"Kessler","year":"2018","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.brs.2021.05.016_bib30","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.jad.2008.03.030","article-title":"Prediction of antidepressant response in both 2.25\u00d7threshold RUL and fixed high dose RUL ECT","volume":"112","author":"Kimball","year":"2009","journal-title":"J\u00a0Affect Disord"},{"key":"10.1016\/j.brs.2021.05.016_bib31","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1007\/s00406-018-0910-6","article-title":"A\u00a0novel Seizure Quality Index based on ictal parameters for optimizing clinical decision making in electroconvulsive therapy. Part 1: development","volume":"268","author":"Kranaster","year":"2018","journal-title":"Eur Arch Psychiatr Clin Neurosci"},{"key":"10.1016\/j.brs.2021.05.016_bib32","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1007\/s00406-018-0962-7","article-title":"A\u00a0novel seizure quality index based on ictal parameters for optimizing clinical decision-making in electroconvulsive therapy. Part 2: Validation","volume":"269","author":"Kranaster","year":"2019","journal-title":"Eur Arch Psychiatr Clin Neurosci"},{"key":"10.1016\/j.brs.2021.05.016_bib33","first-page":"95","article-title":"An electrophysiological biomarker that may predict treatment response to ECT","volume":"35","author":"Scangos","year":"2019","journal-title":"J\u00a0ECT"},{"key":"10.1016\/j.brs.2021.05.016_bib34","first-page":"1644","article-title":"The ictal EEG in ECT: a systematic review of the relationships between ictal features, ECT technique, seizure threshold and outcomes","volume":"13","author":"Francis-Taylor","year":"2020","journal-title":"Brain Stimul Basic Transl Clin Res Neuromodulation"},{"key":"10.1016\/j.brs.2021.05.016_bib35","first-page":"140","article-title":"Poor interrater reliability of MECTA EEG recordings of ECT seizure duration","volume":"50","author":"Guze","year":"1989","journal-title":"J\u00a0Clin Psychiatr"},{"key":"10.1016\/j.brs.2021.05.016_bib36","first-page":"158","article-title":"ECT seizure duration: reliability of manual and computer-automated determinations","volume":"11","author":"Krystal","year":"1995","journal-title":"Convuls Ther"},{"key":"10.1016\/j.brs.2021.05.016_bib37","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/0006-3223(92)90012-O","article-title":"Interrater reliability of seizure duration in ECT","volume":"31","author":"Lambert","year":"1992","journal-title":"Biol Psychiatr"},{"key":"10.1016\/j.brs.2021.05.016_bib38","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s00406-019-01046-5","article-title":"Overlooking the obvious? Influence of electrolyte concentrations on seizure quality parameters in electroconvulsive therapy","volume":"270","author":"Belz","year":"2020","journal-title":"Eur Arch Psychiatr Clin Neurosci"},{"key":"10.1016\/j.brs.2021.05.016_bib39","first-page":"450","article-title":"Effects of the Anaesthetic-ECT time interval and ventilation rate on seizure quality in electroconvulsive therapy: a prospective randomised trial","volume":"13","author":"Taylor","year":"2020","journal-title":"Brain Stimul Basic Transl Clin Res Neuromodulation"},{"key":"10.1016\/j.brs.2021.05.016_bib40","first-page":"287","article-title":"New evidence for seizure quality improvement by hyperoxia and mild hypocapnia","volume":"30","author":"Aksay","year":"2014","journal-title":"J\u00a0ECT"},{"key":"10.1016\/j.brs.2021.05.016_bib41","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1159\/000509113","article-title":"Modified anesthesia protocol for electroconvulsive therapy permits reduction in aerosol-generating bag-mask ventilation during the COVID-19 pandemic","volume":"89","author":"Luccarelli","year":"2020","journal-title":"Psychother Psychosom"}],"container-title":["Brain Stimulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1935861X21001170?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1935861X21001170?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T14:20:19Z","timestamp":1761834019000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1935861X21001170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":41,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["S1935861X21001170"],"URL":"https:\/\/doi.org\/10.1016\/j.brs.2021.05.016","relation":{},"ISSN":["1935-861X"],"issn-type":[{"value":"1935-861X","type":"print"}],"subject":[],"published":{"date-parts":[[2021,7]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Changes in seizure duration during acute course electroconvulsive therapy","name":"articletitle","label":"Article Title"},{"value":"Brain Stimulation","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.brs.2021.05.016","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 The Authors. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}