Lowering the seizure threshold in electroconvulsive therapy using transcranial magnetic stimulation: A case report

Abstract

We demonstrate the feasibility of lowering the seizure threshold using a combined approach of electroconvulsive therapy and transcranial magnetic stimulation. High-frequency transcranial magnetic stimulation of the supplementary motor area shortly before each electroconvulsive treatment session resulted in a reduction of the seizure threshold by half in a male patient with a severe psychotic depressive episode of bipolar affective disorder.

Keywords

• Adverse effect
• Lowering seizure threshold
• RUL ECT
• TMS pre-stimulation
• Ultra-brief pulse