Post-seizure EEG fractal dimension of first ECT predicts antidepressant response at two weeks

Background: Duration of seizure by itself is an insufficient criterion for a therapeutically adequate seizure in ECT. Therefore, measures of seizure EEG other than its duration need to be explored as indices of seizure adequacy and predictors of treatment response. We measured the EEG seizure using a geometrical method-fractal dimension (FD) and examined if this measure predicted remission. Methods: Data from an efficacy study on melancholic depressives (n = 40) is used for the present exploration. They received thrice or once weekly ECTs, each schedule at two energy levels - high or low energy level. FD was computed for early-, mid- and post-seizure phases of the ictal EEG. Average of the two channels was used for analysis. Results: Two-thirds of the patients (n = 25) were remitted at the end of 2 weeks. As expected, a significantly higher proportion of patients receiving thrice weekly ECT remitted than in patients receiving once weekly ECT. Smaller post-seizure FD at first ECT is the only variable which predicted remission status after six ECTs. within the once weekly ECT group too, smaller post-seizure FD was associated with remission status. Conclusions: Post-seizure FD is proposed as a novel measure of seizure adequacy and predictor of treatment response. Clinical implications: Seizure measures at first ECT may guide selection of ECT schedule to optimize ECT. Limitations: The study examined short term antidepressant effects only. The results may not be generalized to medication-resistant depressives. (C) 1999 Elsevier Science B.V. All rights reserved.

Antiangiogenic VEGF-Ax: A New Participant in Tumor Angiogenesis

The transcript of the angiogenic factor vascular endothelial growth factor A (VEGF-A) is subject to a multitude of stimulus-dependent, posttranscriptional regulatory events, consistent with its unusually long 30 untranslated region. We have recently reported translational readthrough of VEGFA mRNA whereby translating ribosomes traverse the canonical stop codon to a conserved, downstream stop codon, generating VEGF-Ax (''x'' for extended), a novel, extended isoform with an additional 22 amino acids appended at the C-terminus. This event is the first vertebrate example of protein-regulated, programmed translational readthrough that generates a protein with a known function. Remarkably, VEGF-Ax exhibits potent antiangiogenic activity, both in vitro and in vivo, thus raising profound clinical implications, particularly with respect to cancer treatment. In this review, we discuss the potential of VEGF-Ax as a therapeutic agent and drug target, as well as its possible role in the failure of, or resistance to, conventional anti-VEGF therapies in many types of cancers. (C) 2015 AACR.