{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:59:32Z","timestamp":1793084372377,"version":"4.5.0"},"reference-count":68,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,12]],"date-time":"2021-06-12T00:00:00Z","timestamp":1623456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>In electroconvulsive therapy (ECT), ictal characteristics predict treatment response and can be modified by changes in seizure threshold and in the ECT technique. We aimed to study the impact of ECT procedure-related variables that interact during each session and might influence the seizure results. Two hundred and fifty sessions of bilateral ECT in forty-seven subjects were included. Seizure results were evaluated by two different scales of combined ictal EEG parameters (seizure quality index (SQI) and seizure adequacy markers sum (SAMS) scores) and postictal suppression rating. Repeated measurement regression analyses were performed to identify predictors of each session\u2019s three outcome variables. Univariate models identified age, physical status, hyperventilation, basal oxygen saturation, days between sessions, benzodiazepines, lithium, and tricyclic antidepressants as predictors of seizure quality. Days elapsed between sessions, higher oxygen saturation and protocolized hyperventilation application were significant predictors of better seizure quality in both scales used in multivariate models. Additionally, lower ASA classification influenced SQI scores as well as benzodiazepine use and lithium daily doses were predictors of SAMS scores. Higher muscle relaxant doses and lower applied stimulus intensities significantly influenced the postictal suppression rating. The study found several modifiable procedural factors that impacted the obtained seizure characteristics; they could be adjusted to optimize ECT session results.<\/jats:p>","DOI":"10.3390\/brainsci11060781","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T10:30:25Z","timestamp":1623666625000},"page":"781","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Factors Predicting Ictal Quality in Bilateral Electroconvulsive Therapy Sessions"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7877-7341","authenticated-orcid":false,"given":"Aida","family":"de Arriba-Arnau","sequence":"first","affiliation":[{"name":"Neurosciences Group\u2014Psychiatry and Mental Health, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL), Department of Psychiatry, Hospital Universitari de Bellvitge-ICS, 08907 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Dalmau Llitjos","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Reanimation and Pain Clinic, Bellvitge University Hospital-ICS, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"},{"name":"Department of Clinical Sciences, School of Medicine, Faculty of Medicine and Health Sciences, Campus Bellvitge, Universitat de Barcelona (UB), 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6412-6831","authenticated-orcid":false,"given":"Virginia","family":"Soria","sequence":"additional","affiliation":[{"name":"Neurosciences Group\u2014Psychiatry and Mental Health, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL), Department of Psychiatry, Hospital Universitari de Bellvitge-ICS, 08907 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain"},{"name":"Department of Clinical Sciences, School of Medicine, Faculty of Medicine and Health Sciences, Campus Bellvitge, Universitat de Barcelona (UB), 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stelania","family":"Savino","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Reanimation and Pain Clinic, Bellvitge University Hospital-ICS, L\u2019Hospitalet de Llobregat, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5320-331X","authenticated-orcid":false,"given":"Neus","family":"Salvat-Pujol","sequence":"additional","affiliation":[{"name":"Neurosciences Group\u2014Psychiatry and Mental Health, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL), 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Biom\u00e8dica de Bellvitge (IDIBELL), Department of Psychiatry, Hospital Universitari de Bellvitge-ICS, 08907 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain"},{"name":"Department of Clinical Sciences, School of Medicine, Faculty of Medicine and Health Sciences, Campus Bellvitge, Universitat de Barcelona (UB), 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikel","family":"Urretavizcaya","sequence":"additional","affiliation":[{"name":"Neurosciences Group\u2014Psychiatry and Mental Health, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL), Department of Psychiatry, Hospital Universitari de Bellvitge-ICS, 08907 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, 28029 Madrid, Spain"},{"name":"Department of Clinical Sciences, School of Medicine, Faculty of Medicine and Health Sciences, Campus Bellvitge, Universitat de Barcelona (UB), 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/acps.13075","article-title":"Electroconvulsive therapy in bipolar depression\u2014effectiveness and prognostic factors","volume":"140","author":"Popiolek","year":"2019","journal-title":"Acta Psychiatr. 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