Evaluating the Efficacy of Convulsion Induced by ECT by Pupil Reactions

Abstract

Sympathetic nervous system activation is recommended to assess adequate seizure in electroconvulsive therapy（ECT）. However, blood pressure and heart rate are not typically assessed as part of sympathetic nervous system activation because of the administration of anesthetic or cardiovascular agents during ECT. Although the pupils are known to reflect the activity of the autonomic nervous system, previous studies have not examined the efficacy of pupil reactivity in assessing ECT. We conducted 98 sessions of ECT with 13 patients divided into two groups according to adequate or inadequate to seizure quality. Pupillary response（% constriction：［MAX-MIN］/MAX × 100 ［%］）was measured using a portable infrared quantitative pupillometer just after electrical stimulation. Pupil constriction was significantly reduced in the adequate group（2.5±3.6 vs. 10.6±11.5%, p<0.0001）compared with the inadequate group. The current findings suggest that pupil constriction immediately after ECT could provide a helpful method for assessing the efficacy of ECT.