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Computational Models of Electroconvulsive Therapy and Transcranial Direct Current Stimulation for Treatment of Depression

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Computational Models of Electroconvulsive Therapy and Transcranial Direct Current Stimulation for Treatment of Depression GRADUATE SCHOOL OF BIOMEDICAL ENGINEERING Computational Models of Electroconvulsive Therapy and Transcranial Direct Current Stimulation for Treatment of Depression Siwei Bai Dissertation submitted in fulfillment of the requirements for the degree of Doctor of Philosophy 2012 PLEASE'IYPE THE UNIVERSI1Y OF HEW SOUTll WAL£S ThoSis/D~IIon S ~OEt Sumome "' F/ttr'oty narrr Bar Fnl nll!l'e St..... T~lle Coll'!putntlonal._'oc!els ()f Elewocorwulslve_ T"era:pY anttlransoran al otroor Curren~ Stlmulat on fcf T!l!Dimenl c.l Oes><es~on Abt lr.u;l 350 wordt maximum: (PLEASE TYPE) EltdtOCM'I<lfS .e I"""''J')' (ECT} and !RIIsaanial d•ld CL<IIOIIIImlil;l1 on ~DCS) are IY.'O irTporta<JI forrrs of transCI'Ill'lai fteeillc<IIII~OOO " ~,...., p$)cholllly Tiley na.., .,.,...., Mj1te$S o.e ~~ e rtWtsln llle ere•-,.. a! maJO( depression aN "'"•• poyet>oofn< -•rs Tl1e aln ollhs thet.s wu to ~e.op,.,...., comw.at.,.,al moc:eto ol ECT andiOCS 10 ~-~ "'tte r..,-,.,.. -!al'odong ot ·nose lv.o bnl n·sttr••atioo IOCI'riquts. 10 IJtl)lore possible re..,_n:s and omprowmools In !Teal.,.... el'bcy Hea<l mooecs ollln6 _.,.. •ubJeeG -·<eeon>IIU<:ed ~om ooue$J)Oildtng oorr~c!ed tomography (CT) or magr.,t e ruonance rmaging II.'RI) scans One was a ro•Mesotvt oo model rendered from a set of CT ocano l!>corpo<abng s~l.il l concliC'ivoly"' 500JOO>\'. The other :wo -• htgn. resok.JI•on ,oatts recormn.tded from MR• scans Wth one lnc.crporatlng "m te matter conducfivity anisotropy In oath nlgtl·resoU on modets, SC"o'etJI bralo c011 cal regions of inte-reSl were. segmer'lled anct dellncd; these 1re ~ 'o be involv@d In Ulernpe-vtlc or edvar$e sumu af.an O\.JiOOfi'IOS In crte set o-r s.lmuta1 ons these sllutt\Jr81 head models ~Nere teken 10 be pass1-ve Vg'I..Q'lle cOI'II.t\leiOI'$. to lnvesugate tne efect of vatious.­ alectrode montages on the dislrib<ution t>f current density or e1ectric rtold W!lhin 1r1e head. Results 5howed that current dislribU on in Chc bfa1n was tllgnly dopendont on lhe electrooe placement on IM seatp, For example. wt>en simulating tnree d,ffi!Ienlligl\1 ooitaterol (RUL) ECT moolage•. tne non-convenlionnl mom ages vAI.h an eleelrOCfe en- I he fO Tehead epoeat"eo 10 have supcttotily Ot,;ij:r eonvenuonaii~Ul. becouso sl lnM.IIatioo strength WM Sl tOfl90f In reglof'IS bO'IeVOO tesQOnslble for the 11eatmen1 efflcacy. sud1 fl$ the E~ntelior ei11Q'lllate gyru.s and was \'AJ&ket' In rngions that have been speCtJtoled to e)(ert adverse effects. such as lho hlppocampu5 In o<kJition. 8 contmuum aet1ve model or netnl exGitaUOn \.. as I ISO devotoped to simulate c:trreet activatiOn cf lhre br&ln fOllOWing an ECT sttmCJ&us Ttn mOdel waslnlegratea Into tl"e pa:sswe heaa mOdel to invesrlg.ale 1110 W1vence ot dlffe•ent elec:trode pi..J~ments as 'Mlll as the ,rme· dependenl et'ects of ECT SIJmUus parametets on btal'1 ec!MIIi<M1 F04' tf'stJ,ce. v.neo lhe .stimulus pulse wfcllh WJS reduced. max mUI'T'I OJrrent density YmS tJ~ cut the spaLaf extent c• ad vauonv.as tedvee<l Mcao..er. resul!S showt!a tt'lat sumolus lreque:ncy lnlluellOed the sc1muhts ellldency tNII is. cia lire bfoi1 neu:rli>Sil>al were al:>le 10 be dr..:Uy ae6•ated t>y a "'"9'• pulse. 80%. 1~ ano 0% _.., cap.-.bla of beillg e<l>~aled t>y t>ot• ollv.o conse<•1•"' O'.r!ses ""lh lrecue<100S oii!O Hz 90Hz ar4 120Hz re5!>-"dively DoclaraUon rotaUng to di spos.ftfon of profect LhH isldl ssortltion I ne·eby grant lo lhe Llnlver$41)' 01New S-cutt. Wales or 1ts age.~ s the r1ght1o aft"~ anc to mel(e avalt.able my t.hUIS ar dissertnon in Whole or'" part In the Unlvorsltv libraries i11 ell fOf'l1"tS of media. now or here 11rter ltoOY.'n, subJect lD the pro\isions ot the Copyr~N Aot 1968 re~a!n a!t propeHy tlgh11. iUCh as patenl rights. I atso retain th~ right to use In rutore works (such as artlcles or books.) all or part or this thesis Ot' dlssertahon ill-SO AIJihOfise Untve"'iY Mrctofilms to use the 350 WOld abs,rool ol my thesis 10 DJssertafion Abs-tracts International {thl$ •• 8PQIICObte to doctoral theses on'y) c..'\~ ....... .. The U1 ..nlly-lnl! !here may be OJ((OPI!Onal ~tan:M requrring rest'ICIMlnS on copying <X cmdll..,. on""' Requests lot resuc110n Ia< a penco olup 10 ~)1!0'$ 'TlUSI te mMOin wrbng R~ Iota longer period ol reslr>d'"" may to eor.sidered In exceptional ua.rsc.ances a no recuire tre aDorova. of tt-e Dean ol Gr~e Research 1 FOR OFFlCE use ONLY THIS SHEET IS 'TO BE ClLUEO TO THE INSIDE FRONT COVER OF THE THESIS ORJGJNAUTY STATEMENT 'l hereby declare that this submission is my own work and to the best of my knowledge it contains no materials previously published or wrtUen by another person, or substantial proportions of material which have been accepted for the award of any other degree or diploma at UNSW or any other educational institution, except where due acknowledgement is made in the thesis. Any ccntribution made to the research by others, with whom I have worked at • UNSW or elsewhere is explicitly acknO\vtedged 1n the thesis I also declare that the intellectual ccntent of this thesis is lhe product of my own work, except to lhe eXIent that assistance from others in the project's design and conception or in style, presentation and linguistic expression is acknowledged.' Signed .......~ . ... .... -.. Date ........... .... .'3,/~ .3/~rJ. .. COPYRIGHT STATEMENT 'I hereby grant lhe Unwersity of New South Wales or its agents the righ1 to arcllive and to make available my thesis Of dissertation In whole or part in the Unll/ersity libraries in all forms of medta now or here after known. subject to the provisions of the Copyright Act 1968. I retain all proprietary nghts, such as patent rights. I also retain the right to use in future works (such as articles or Docks) all or part of this thests or aissertation I also authorise Univers~y Microfilms to use the 350 word abstract of my thesis In Dissertation Abstract International (this is applicable to doctoral theses only) I have either used no substantial portions of copyright material in my thesis or I have obtained permission to use copyright material: where permission has not been granted I have applied/will apply for a partial restriction of the digital copy of my thesis or dissertation ' Signed ......... ~ ............................ Date .. l ~~~}/~.' L ... ..................... AUTHENTICITY STATEMENT 'I certiiy thal the Library deposit digital copy js a direct equivalent of (he Final officially approved version of m·y thesis. No emendation of content has occurred and if there are any minor variations in formatting, they are the resuH of the conversion to digital format.' Signed .......... ......._ fu.... ....... ~ .................. .. d/o~/.U/~ Data ... .. ... ... ···-··· .Z..... .. ,.... .. ....................... The Brain — is wider than the Sky — For — put them side by side — The one the other will contain With ease — and You — beside — The Brain is deeper than the sea — For — hold them — Blue to Blue — The one the other will absorb — As Sponges — Buckets — do — The Brain is just the weight of God — For — Heft them — Pound for Pound — And they will differ — if they do — As Syllable from Sound — — Emily Dickinson i Acknowledgements As the ending of this latest stage of my educational journey approaches, it is a great pleasure to reminisce about these bygone bittersweet days, and give respect to the kind people who shared with me this journey. Above all, it would not have been possible to write this doctoral thesis without the help, support and patience of my principal supervisor, A/Prof. Socrates Dokos, not to mention his advice and unsurpassed knowledge in the field of computational modelling. The invaluable advice and support from my co-supervisor, Prof. Colleen Loo, has been of great significance throughout the tenure of my PhD candidature, for which I am extremely grateful. I would like to acknowledge the financial, academic and technical support of the University of New South Wales and its staff, particularly in the University International Postgraduate Award that provided the necessary financial assistance for this research. I also owe sincere and earnest thankfulness to the Graduate School of Biomedical Engineering, where I spent one of the most precious four-year periods in my life, for their indispensable support and assistance since the beginning of my postgraduate work in 2009, especially the current Head of School, Prof. John Whitelock, who kindly chaired my annual review panel and offered me many constructive suggestions. I am most grateful to Dr. Elizabeth Tancred and A/Prof. Pascal Carrive for their benevolent support and encouragement during my study of the neuroanatomy course. I would like to offer my gratitude to Prof. Caroline Rae and Dr. John Geng from Neuro- science Research Australia for their support in acquiring and processing the magnetic resonance imaging data, and to Dr. Angelo Alonzo and Dr. Donel Martin for their assistance in determining electrode placements for transcranial direct current stimula- ii tion. Amongst my fellow postgraduate students in the Graduate School of Biomedical Engineering, the guidance I received from Dr. Amr Al Abed and Dr. Andrew Sims in finite element analysis, as well as the help from Mr.
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