Memory Impairment Following Electroconvulsive Therapy in Chinese Patients with Schizophrenia: Meta-Analysis of Randomized Controlled Trials

Zheng, Wei; Guo, Tong; Ungvári, Gábor S.; Ng, Chee H.; Chiu, Helen Fung Kum; Xiang, Ying; Cao, Xiao; Liu, Zheng Rong; Meng, Li Rong; Gazdag, Gábor; Xiang, Yu‐Tao

doi:10.1111/ppc.12206

Cited by 18 publications

(6 citation statements)

References 16 publications

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“…For other noninvasive brain stimulations, such as transcranial direct current stimulation (tDCS) (42)(43)(44) and electroconvulsive therapy (45,46), another objective is to monitor the cognitive effects of rTMS. Consistent with previous meta-analyses focusing on adult patients with MDD (47,48), this systematic review also found that a therapeutic rTMS course for child and adolescent patients with FEDN MDD may produce modest cognitive enhancing effects.…”

Section: Discussionmentioning

confidence: 99%

Low-frequency repetitive transcranial magnetic stimulation for children and adolescents with first-episode and drug-naïve major depressive disorder: A systematic review

et al. 2023

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ObjectiveThis systematic review of randomized controlled trials (RCTs) was conducted to explore the therapeutic effects and safety of active low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) versus sham LF-rTMS in children and adolescent patients with first-episode and drug-naïve (FEDN) major depressive disorder (MDD).MethodsA systematic literature search was performed, and data were extracted by two independent researchers. The coprimary outcomes were study-defined response and remission.ResultsA systematic search of the literature yielded 442 references, of which 3 RCTs (130 children and adolescents with FEDN MDD, 50.8% male, and mean age range from 14.5 to 17.5 years) met the inclusion criteria. Among the two RCTs (66.7%, 2/3) examining the effects of LF-rTMS on study-defined response and remission and cognitive function, active LF-rTMS was more efficacious than sham LF-rTMS in terms of study-defined response rate and cognitive function (all p < 0.05) but not regarding study-defined remission rate (all p > 0.05). No significant group differences were found with regard to adverse reactions. None of the included RCTs reported the dropout rate.ConclusionThese findings preliminarily found that LF-rTMS could benefit children and adolescents with FEDN MDD in a relatively safe manner, although further studies are warranted.

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Section: Discussionmentioning

confidence: 99%

Low-frequency repetitive transcranial magnetic stimulation for children and adolescents with first-episode and drug-naïve major depressive disorder: A systematic review

et al. 2023

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“…Despite clear evidence of the symptomatic effectiveness of ECT in patients with schizophrenia, there remains a controversy on the cognitive side effects of ECT. Although randomised controlled trials have suggested greater transient memory impairment in treatments of ECT combined with antipsychotics when compared with antipsychotic monotherapy for Chinese patients with schizophrenia, 16,34 ECT-induced acute cognitive impairments typically resolved within several weeks after the last ECT session. 35,36 Our results is in agreement with recent studies demonstrating cognitive improvement after ECT in patients with schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

Effects of electroconvulsive therapy on cognition and quality of life in schizophrenia

Tan

Lim

Martin

et al. 2022

Ann Acad Med Singap

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Introduction: The effects of electroconvulsive therapy (ECT) on quality of life (QoL), and its relationship with symptom and cognitive change remains unclear. We aim to examine the association of QoL changes with psychiatric symptom and cognitive changes among patients with schizophrenia who underwent ECT. Methods: This is a retrospective cohort study of 132 patients who received ECT from July 2017 to December 2019. Sociodemographic and clinical characteristics were obtained from medical records. Changes in QoL, psychiatric symptoms and cognition function were examined after 6 sessions of ECT. Generalised linear regression was used to examine the associations of Brief Psychiatric Rating Scale (BPRS) scores and Montreal Cognitive Assessment (MoCA) scores with QoL as measured by EQ-5D scores. Results: The mean (standard error) improvements after ECT were statistically significant for the assessment scales of EQ-5D utility score: 0.77 (0.02) to 0.89 (0.02), P<0.001; EuroQol-5-Dimension (EQ-5D) visual analogue scale score: 66.82 (2.61) to 73.05 (1.93), P=0.012; and EQ-5D subdomain scores. Both improvement in BPRS (adjusted β coefficient -0.446, 95% confidence interval [CI] -0.840 to -0.052) and MoCA (adjusted β 12.068, 95% CI 0.865 to 12.271) scores were significantly associated with improvement in EQ-5D utility scores after adjustment for sociodemographic and clinical characteristics. Improvement of BPRS scores (psychiatric symptoms) was significantly associated with improvement of the patients’ mental health that was assessed by EQ-5D subdomain scores of pain (adjusted β coefficient 0.012, 95% CI 0.004 to 0.021) and anxiety (adjusted β coefficient 0.013, 95% CI 0.002 to 0.024). Improvement of MoCA scores (cognitive function) was significantly associated with patients’ physical health as assessed by EQ-5D subdomain score of usual activity (adjusted β coefficient -0.349, 95% CI -0.607 to -0.09). Conclusion: ECT was associated with an overall improvement of QoL among patients with schizophrenia. The improvement of psychiatric symptoms was found to be significantly associated with better mental health while the improvement of cognitive function was associated with better physical health. Keywords: Cognitive function, electroconvulsive therapy, psychiatric symptoms, quality of life, schizophrenia

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“…Recent efforts to further reduce cognitive side effects focus on changing from brief to ultra brief pulse stimulation[45]. While a few individual testimonies reported longlasting and severe memory disturbances after ECT[46], extensive psychological tests could not detect significant memory deficits beyond six months following a course of ECT[47].…”

Section: Place Of Electroconvulsive Therapy In Modern Psychiatrymentioning

confidence: 99%

Electroconvulsive therapy: 80 years old and still going strong

Gazdag

Ungvári

2019

WJP

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Electroconvulsive therapy (ECT), which is among the oldest and most controversial treatments in the field of psychiatry, has its 80th birthday this year. In this brief historical overview, the discovery of the therapeutic effects of convulsive therapy by Laszló Meduna, and the circumstances that motivated Ugo Cerletti and Lucio Bini to use electricity as a means of seizure induction are described. Meduna’s original theory about the antagonism between epilepsy and schizophrenia has been replaced by hypotheses on the mechanism of action of ECT. The position of ECT in modern psychiatry is also discussed with special attention to its most important clinical indications, including catatonia, and pre- and postpartum affective and psychotic states that are responsive to ECT and in which ECT may even be lifesaving. Adverse effects and comparison of ECT with recently developed brain stimulation methods are also reviewed. The negative media portrayal of ECT and its earlier misuse may have contributed to its negative professional and public perceptions indicated repeatedly in attitude surveys. This negative attitude has played an important role in the decreasing use of ECT in the developed world and a reduction in access to ECT, which constitutes a violation of psychiatric patients’ right to an effective treatment.

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Memory Impairment Following Electroconvulsive Therapy in Chinese Patients with Schizophrenia: Meta-Analysis of Randomized Controlled Trials

Abstract: The ECT-AP combination was associated with greater transient memory impairment compared to AP monotherapy.

Cited by 18 publications

References 16 publications

Low-frequency repetitive transcranial magnetic stimulation for children and adolescents with first-episode and drug-naïve major depressive disorder: A systematic review

Low-frequency repetitive transcranial magnetic stimulation for children and adolescents with first-episode and drug-naïve major depressive disorder: A systematic review

Effects of electroconvulsive therapy on cognition and quality of life in schizophrenia

Electroconvulsive therapy: 80 years old and still going strong

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