Ictal electroencephalographic correlates of posttreatment neuropsychological changes in electroconvulsive therapy: a hypothesis-generation study.
OBJECTIVE
Electroconvulsive therapy (ECT) has been associated with memory and neuropsychological changes, but which features of ECT are associated with those changes have not been well investigated. The aim of this hypothesis-generation study was to examine correlations between ictal electroencephalographic (EEG) characteristics and cognitive side effects after ECT.


METHODS
Eight patients with major depressive disorder were examined with the Wechsler Memory Scale-Revised (WMS-R), the Stroop test, the Trail Making Test, and verbal fluency before and after ECT treatment. Seven ictal EEG measurements (eg, slow-wave phase amplitude, postictal suppression) were manually rated by 3 independent psychiatrists. The correlations between ictal EEG measurements, changes in WMS-R subset scores, and non-memory-related neuropsychological assessments were examined with Spearman rank correlation.


RESULTS
Verbal memory, general memory, attention/concentration, delayed memory of WMS-R subset scores, and the Stroop test scores improved significantly after ECT treatment. Postictal suppression and slow-wave amplitude correlated positively with delayed memory and visual/verbal discrepancy score. Slow-wave amplitude correlated negatively with letter fluency. The longer the polyspike wave duration, the higher the attention/concentration test results.


CONCLUSIONS
Certain ictal EEG measurements were associated with changes in several neuropsychological test results that had improved 2 weeks after the final ECT treatment. A hypothesis-testing study with a larger sample is needed to verify the relationships between EEG measurements and neuropsychological test performance.
Azuma
Hideki
H
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. azma@med.nagoya-cu.ac.jp
Fujita
Akiko
A
Otsuki
Kazuyuki
K
Nakano
Yumi
Y
Kamao
Takahiro
T
Nakamura
Chie
C
Fujioi
Junko
J
Otake
Hirohumi
H
Nishigaki
Makoto
M
Suzuki
Masako
M
Kataoka
Miyako
M
Matsuzawa
Takahiro
T
Sonoda
Manabu
M
Nakaaki
Shutaro
S
Murata
Yoshie
Y
Akechi
Tatsuo
T
Furukawa
Toshi A
TA
D000328:Adult; D001288:Attention; D003865:Major Depressive Disorder / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests