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

Published online by Cambridge University Press:  24 March 2014

G. Fernie ,
D. M. Bennett ,
J. Currie ,
J. S. Perrin  and
I. C. Reid
G. Fernie*
Affiliation:
Division of Applied Medicine (Psychiatry), University of Aberdeen, Aberdeen, UK Scottish Mental Health Research Network, NHS Research Scotland, Edinburgh, UK
D. M. Bennett
Affiliation:
Division of Applied Medicine (Psychiatry), University of Aberdeen, Aberdeen, UK
J. Currie
Affiliation:
Division of Applied Medicine (Psychiatry), University of Aberdeen, Aberdeen, UK
J. S. Perrin
Affiliation:
Division of Applied Medicine (Psychiatry), University of Aberdeen, Aberdeen, UK
I. C. Reid
Affiliation:
Division of Applied Medicine (Psychiatry), University of Aberdeen, Aberdeen, UK
*
*Address for correspondence: G. Fernie, Ph.D., Division of Applied Medicine (Psychiatry), School of Medicine and Dentistry, University of Aberdeen, Clinical Research Centre, Royal Cornhill Hospital Grounds, Aberdeen AB25 2ZH, UK. (Email: g.fernie@abdn.ac.uk)
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Abstract

Background

Electroconvulsive therapy (ECT) is an effective treatment for depression but the extent and persistence of cognitive side-effects remain uncertain. It has been reported that there is little evidence that impairments last longer than up to 15 days post-ECT. However, relatively few studies have followed patients for even as long as 1 month post-ECT. Here we report results from a brief cognitive battery given prior to ECT and repeated five times up to 6 months post-ECT.

Method

In a retrospective case-note study of routinely collected clinical data 126 patients treated with ECT completed two neuropsychological tests [Cambridge Neuropsychological Test Automated Battery (CANTAB) spatial recognition memory (SRM) and Mini Mental State Examination (MMSE)] and two subjective reports of memory function, prior to ECT. Patients were reassessed following ECT and at 1, 3 and 6 months post-ECT although not all patients completed all assessments.

Results

Performance relative to pre-ECT baseline was significantly poorer at each post-ECT assessment up to 3 months post-ECT using the CANTAB SRM, but was improved at 6 months. Conversely, MMSE score showed improvements relative to baseline from 1 month post-ECT. Mood and subjective memory scores improved following ECT and were correlated with one another, but not with either neuropsychological measure.

Conclusions

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.

Keywords

Depressionelectroconvulsive therapy (ECT)memorymood disorder
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 14 , October 2014 , pp. 2985 - 2994
Copyright
Copyright © Cambridge University Press 2014 

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