{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:52:43Z","timestamp":1777524763376,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009228","name":"Region \u00d6rebro l\u00e4n","doi-asserted-by":"publisher","award":["OLL\u2010997051"],"award-info":[{"award-number":["OLL\u2010997051"]}],"id":[{"id":"10.13039\/501100009228","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Seizure duration during electroconvulsive therapy (ECT) correlates with treatment efficacy and may be influenced by depth of anaesthesia. The Patient State Index (PSi), derived from processed EEG, offers a potential method to monitor depth of anaesthesia during ECT. This study examined the correlation between pre\u2010ictal PSi and EEG\u2010seizure duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective observational study, adult patients undergoing routine ECT at a Swedish university hospital were monitored using the SedLine pEEG system. Anaesthetic care followed standard protocols and the clinical team was blinded to PSi values. Pre\u2010ictal PSi was defined as the final value prior to the ECT stimulus. EEG\u2010seizure duration and relevant clinical variables were extracted from health records. The primary outcome was the association between pre\u2010ictal PSi and EEG\u2010seizure duration, analysed using a linear mixed\u2010effects model adjusting for age and use of benzodiazepines or anticonvulsants. Secondary analyses explored sex and age effects on PSi over time and differences between baseline and pre\u2010ictal PSi.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010seven ECT sessions in 37 patients were analysed. Median baseline PSi was 94 (IQR 4) and pre\u2010ictal PSi was 38 (IQR 31;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). No correlation was found between pre\u2010ictal PSi and EEG\u2010seizure duration. There were no significant effects of age or sex on pre\u2010ictal PSi while there was a significant difference between sexes on baseline PSi. Artefact and EMG activity in the EEG signal were minimal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pre\u2010ictal PSi was not associated with EEG\u2010seizure duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Editorial Comment<\/jats:title>\n                    <jats:p>This study found no evidence to support a correlation between pre\u2010ictal Patient State index and seizure duration, thereby challenging any clinical utility for guiding ECT administration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.70152","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T07:05:02Z","timestamp":1763535902000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Depth of Anaesthesia Measured by Patient State Index (\n                    <scp>PSi<\/scp>\n                    ) Does Not Correlate With Increased Seizure Duration During Electroconvulsive Therapy"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7518-8915","authenticated-orcid":false,"given":"Pether","family":"Jildenst\u00e5l","sequence":"first","affiliation":[{"name":"Department of Health Sciences Lund University  Lund Sweden"},{"name":"Department of Anaesthesiology, Surgery and Intensive Care Medicine Sahlgrenska University Hospital  Gothenburg Sweden"},{"name":"Department of Anaesthesia and Intensive Care, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"},{"name":"Faculty of Nursing and Health Sciences Nord University  Bod\u00f8 Norway"},{"name":"Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel","family":"Nordenskj\u00f6ld","sequence":"additional","affiliation":[{"name":"University Health Care Research Center, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e5ns","family":"Edstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1610-7165","authenticated-orcid":false,"given":"Alexander","family":"Otterbeck","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Faculty of Medicine and Health \u00d6rebro University  \u00d6rebro 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