Cognitive Performance Under Electroconvulsive Therapy (ECT) in ECT-Naive Treatment-Resistant Patients With Major Depressive Disorder.
OBJECTIVE
Although electroconvulsive therapy (ECT) is considered a safe and highly effective treatment option for major depressive disorder, there are still some reservations with regard to possible adverse cognitive adverse effects. This is the case despite a large body of evidence showing that these deficits are transient and that there even seems to be a long-term improvement of cognitive functioning level. However, most data concerning cognitive adverse effects stem from studies using mixed samples of treatment-resistant and non-treatment-resistant as well as ECT-naive and non-ECT-naive subjects. Furthermore, neurocognitive measures might partly be sensitive to practice effects and improvements in depressive symptom level.


METHODS
We examined neurocognitive performance in a sample of 20 treatment-resistant and ECT-naive subjects using repeatable neurocognitive tests, whereas changes in depressive symptom level were controlled. Cognitive functioning level was assessed before (baseline), 1 week, and 6 months (follow-up 1 and 2) after (12 to) 15 sessions of unilateral ECT treatment.


RESULTS
No adverse cognitive effects were observed in any of the cognitive domains examined. Instead, a significant improvement in verbal working memory performance was found from baseline to follow-up 2. When changes in depressive symptom levels were controlled statistically, this improvement was no longer seen.


CONCLUSIONS
Although findings that ECT does not lead to longer lasting cognitive deficits caused by ECT were confirmed, our study adds evidence that previous results of a beneficial effect of ECT on cognition might be questioned.
From the *Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social Foundation Bamberg, Bamberg; †Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg; and ‡Department of Physiological Psychology, Otto-Friedrich University Bamberg, Bamberg, Germany.
Christoph
C
Ziegelmayer
Göran
G
Hajak
Anne
A
Bauer
Marion
M
Held
Rainer
R
Rupprecht
Wolfgang
W
Trapp
D000328:Adult; D000368:Aged; D003071:Cognition; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000523:psychology* / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000009:adverse effects* / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance; D016896:Treatment Outcome; D014706:Verbal Learning