Detecting objective and subjective cognitive effects of electroconvulsive therapy: intensity, duration and test utility in a large clinical sample

Fernie, Gordon; Bennett, Daniel M.; Currie, James; Perrin, Jennifer S.; Reid, Ian

doi:10.1017/s0033291714000658

Cited by 60 publications

(43 citation statements)

References 24 publications

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“…All other tests showed either no change or improvement from baseline to T2 or the end of the index series. In contrast to the results of Falconer et al and Fernie et al, visual and visuospatial memory also remained stable from baseline to T3 (25, 48). Six-month follow-up assessments confirmed stability or further improvement in cognitive performance.…”

Section: Discussioncontrasting

confidence: 96%

“…Our results are in accordance with the majority of recent studies showing stability of cognitive performance as well as improvements in processing speed with ECT in the short-term (baseline to end of index) and long-term (after 6-months) (22, 25, 47, 49, 50). Semkovska, Bodnar, and Fernie reported significant improvement in cognition at varying time points after ECT completion (2 weeks (22), 3 months (50), and 6 months (25) respectively).…”

Section: Discussionsupporting

confidence: 93%

“…Semkovska, Bodnar, and Fernie reported significant improvement in cognition at varying time points after ECT completion (2 weeks (22), 3 months (50), and 6 months (25) respectively). These studies reporting improvements, however, did not assess control subjects.…”

Section: Discussionmentioning

confidence: 99%

“…Two reviews reported that initial cognitive deficits revert back to baseline at 6 months following ECT in all patients (23, 24). In a recent retrospective study, Fernie et al, reported poorer spatial recognition memory performance at each evaluation up to 3 months post-ECT compared to baseline, although performance improved at 6-month follow-up (25). In contrast, one of the largest studies investigating long-term memory outcomes following ECT (n=347) reported that cognitive effects persist at 6-month follow-up, though ECT parameters, and bilateral lead placement specifically, contributed to these findings (26).…”

Section: Introductionmentioning

confidence: 99%

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Short- and Long-term Cognitive Outcomes in Patients With Major Depression Treated With Electroconvulsive Therapy

Vasavada

Leaver

Njau

et al. 2017

J ECT

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Objectives The risk of cognitive impairment is a concern for patients with major depressive disorder (MDD) receiving electroconvulsive therapy (ECT). Here, we evaluate the acute, short-term and long-term effects of ECT on tests of processing speed, executive function, memory, and attention. Methods Forty-four MDD patients receiving ECT (61% right unilateral (RUL), 39% mixed RUL-bitemporal, left UL and/or bitemporal lead placement underwent a cognitive battery prior to ECT (T1), after 2 sessions (T2), and at the end of the index (T3). Thirty-two patients returned for a 6-month follow-up (T4). Thirty-three controls were assessed at two times ~4 weeks apart (C1 and C2). Results At baseline, patients showed deficits in processing speed, executive function and memory compared to controls. Including depression severity and lead placement covariates, linear mixed model analysis showed significant improvement in only processing speed between T1 and T3 and between T1 and T4 in patients. An acute decline in attention and verbal memory was observed at T2, but performance returned to baseline levels at T3. Longitudinal cognitive outcomes did not differ in patients defined as ECT responders/non-responders. Limitations Episodic memory was not measured and medications were not controlled between T3 and T4. Controls also showed improvements in processing speed, suggesting practice effects for some measures. Conclusions In this naturalistic ECT treatment study, results show that the initiation of ECT may transiently affect memory and executive function, but cognition is largely unaffected during and post ECT. While some functions might improve, others will at least remain stable up to 6-months following the ECT index.

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Section: Discussioncontrasting

confidence: 96%

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Short- and Long-term Cognitive Outcomes in Patients With Major Depression Treated With Electroconvulsive Therapy

Vasavada

Leaver

Njau

et al. 2017

J ECT

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“…Among the most common, and the mildest side effects, are headache [16][17][18], nausea or myalgias [19], as well as effects at a cognitive level that are often self-limited and require symptomatic management [20][21][22]. Other more severe but uncommon side effects include cardiac, pulmonary and cerebrovascular disorders.…”

Section: Discussionmentioning

confidence: 99%

Electroconvulsive Therapy: Solution or a Cause of Tardiv Dyskinesia?

María¹

2017

J Depress Anxiety

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A retrospective case series of electroconvulsive therapy in the management of comorbid depression and anorexia nervosa

Shilton

Enoch‐Levy

Giron

et al. 2019

Intl J Eating Disorders

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Objective Major depressive disorder (MDD) is common in anorexia nervosa (AN), associated with worse outcome and greater suicide risk. Electroconvulsive therapy (ECT) is highly effective in the treatment of MDD refractory to antidepressive treatment. We describe a case series of female adolescents with AN receiving ECT for MDD resistant to treatment and/or with severe suicide risk. Method We retrospectively analyzed the files of all 30 adolescent females hospitalized in our department because of AN between 1998 and 2017 and treated with ECT. Severity of eating disorder (ED) and depressive symptoms was retrospectively assessed using the Clinical Global Impression‐Severity Scale. Results Patients were severely depressed and suicidal on admission. All were resistant to antidepressants. A significant deterioration in depression, with severe suicidality, occurred from admission to pre‐ECT, with concomitant improvement in ED symptoms and increase in body mass index (BMI). Significant improvement in depressive and ED symptoms and increase in BMI occurred following ECT, continuing to discharge. Adverse effects were mostly minimal. Fifty‐three percentage of the patients were rehospitalized within the first year after ECT, mostly because of deterioration of depression and attempted suicide. Several years after discharge, 46.6% of the patients had no evidence of depression, suicidality, and ED‐symptomatology, and another 23% had only evidence of ED symptomatology. Discussion ECT is safe and well tolerated in AN with severe comorbid treatment resistant MDD and/or with increased suicide risk. Many AN patients undergoing ECT may be remitted at long‐term follow‐up.

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Detecting objective and subjective cognitive effects of electroconvulsive therapy: intensity, duration and test utility in a large clinical sample

Abstract: The CANTAB SRM task revealed reversible cognitive deficiencies relative to a pre-ECT baseline for at least 3 months following ECT, while MMSE score and patients' subjective reports showed only improvement. Visuospatial memory scores eventually exceeded baseline 6 months post-ECT.

Cited by 60 publications

References 24 publications

Short- and Long-term Cognitive Outcomes in Patients With Major Depression Treated With Electroconvulsive Therapy

Short- and Long-term Cognitive Outcomes in Patients With Major Depression Treated With Electroconvulsive Therapy

Electroconvulsive Therapy: Solution or a Cause of Tardiv Dyskinesia?

A retrospective case series of electroconvulsive therapy in the management of comorbid depression and anorexia nervosa

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