Cognitive functioning in patients treated with electroconvulsive therapy

Abstract

Background: Electroconvulsive therapy (ECT) is an effective treatment method for severe mental illnesses. ECT has gone through significant modernization. Side effects of ECT have largely decreased. Temporary disturbance of cognitive performance can be still present as a side effect of electroconvulsive treatment. Methods: Cognitive functioning in the sample of patients with severe and acute mental illness treated with electroconvulsive therapy (ECT) was assessed. Basic assessment of cognitive functions was applied in the beginning, in the middle, and at the end of ECT course treatment with the Montreal Cognitive Assessment (MoCA). Complex and detailed testing of cognitive functions using the MATRICS Consensus Cognitive Battery (MCCB) was done at two points in time -within the first week of and then 6 weeks after the end of ECT. Results: Participants had cognitive deficits at baseline, which were most likely influenced markedly by the psychopathology of the illness itself. The improvement in cognition came together with the reduction in psychopathology; psychopathology scores were significantly reduced during ECT treatment. Compared to the baseline, all scores for cognitive testing were significantly improved but remained low in comparison with the controls. After 6 weeks, there was further significant improvement. Conclusion: Our results confirm the safety and efficacy of ECT in the treatment of severe mental disorders.

Geriatric Depression and Cognitive Impairment—An Update

“…In a recent case-control study on ECT in acute mental illness, where the mean age of the sample was 50 years, improvement in cognitive functioning was observed. 63 Another study also reported improvement in cognitive aspects with ECT in treatment-resistant depression in older adults. 64 Overall, ECT in older adults for depression may have a more positive effect on cognition though it is known to cause transient acute cognitive deficits.…”

Appraising the effectiveness of electrical and magnetic brain stimulation techniques in acute major depressive episodes: an umbrella review of meta-analyses of randomized controlled trials

“…In addition, long-term short-term memory impairment has been reported in some patients who underwent ECT. 79 Finally, there are still no evidence-based safety recommendations for DBS, 62 although the procedure involves all the risks inherent to a neurosurgical procedure. 80 Our review has several limitations that should be considered.…”

Die Bedeutung der Elektrokonvulsionstherapie (EKT) in der multimodalen Behandlung depressiver Störungen

“…Wenn zusätzliche kognitive Störungen im Rahmen einer EKT-Serie auftreten, sind diese zumeist so ausgeprägt, dass in dieser Zeit in der Regel keine Arbeitsfähigkeit gegeben ist. Die durch die EKT verursachten kognitiven Störungen bestehen nur temporär und bilden sich in der Regel innerhalb eines Zeitraums von 4-8 Wochen nach Abschluss einer EKT-Serie spürbar zurück (Kalisova et al, 2018;Semskova et al, 2010) und sind nach 6 Monaten bei den meisten Patient*innen nicht mehr nachweisbar (Nuninga et al, 2018); dies trifft auch für ältere Patient*innen zu (Obbels et al, 2018). Einzelne Patient*innen berichten über persistierende kognitive Störungen, insbesondere retrograde Amnesien, die zum Teil mit verbleibenden depressiven Symptomen und nicht mit objektiv messbaren Störungen korreliert sind und dann nicht klar von durch die Depression bedingten kognitiven Störungen abgegrenzt werden können (Fernie et al, 2014;Fraser et al, 2008).…”