Using the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess the cognitive impact of electroconvulsive therapy on visual and visuospatial memory.
BACKGROUND
The cognitive impact of electroconvulsive therapy (ECT) is rarely measured systematically in everyday clinical practice even though patient and clinician acceptance is limited by its adverse affect on memory. If patients are tested it is often with simple paper and pencil tests of visual or verbal memory. There are no reported studies of computerized neuropsychological testing to assess the cognitive impact of ECT on visuospatial memory.


METHODS
Twenty-four patients with severe depression were treated with a course of bilateral ECT and assessed with a battery of visual memory tests within the Cambridge Neuropsychological Test Automated Battery (CANTAB). These included spatial and pattern recognition memory, pattern-location associative learning and a delayed matching to sample test. Testing was carried out before ECT, during ECT, within the week after ECT and 1 month after ECT.


RESULTS
Patients showed significant impairments in visual and visuospatial memory both during and within the week after ECT. Most impairments resolved 1 month following ECT; however, significant impairment in spatial recognition memory remained. This is one of only a few studies that have detected anterograde memory deficits more than 2 weeks after treatment.


CONCLUSIONS
Patients receiving ECT displayed a range of visual and visuospatial deficits over the course of their treatment. These deficits were most prominent for tasks dependent on the use of the right medial temporal lobe; frontal lobe function may also be implicated. The CANTAB appears to be a useful instrument for measuring the adverse cognitive effects of ECT on aspects of visual and visuospatial memory.
Falconer
D W
DW
Department of Mental Health, Clinical Research Centre, Royal Cornhill Hospital, University of Aberdeen, Aberdeen AB25 2ZH, UK.
Cleland
J
J
Fielding
S
S
Reid
I C
IC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001245:Association Learning; D003072:Cognition Disorders / Q000175:diagnosis*; D003865:Major Depressive Disorder / Q000628:therapy*; D003936:Diagnosis, Computer-Assisted / Q000706:statistics & numerical data*; D004193:Discrimination Learning; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D009949:Orientation; D010153:Paired-Associate Learning; D010364:Pattern Recognition, Visual; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012153:Retention, Psychology