title: Cognitive training to improve memory in individuals undergoing electroconvulsive therapy: Negative findings.
abstract: Although electroconvulsive therapy (ECT) remains the most effective treatment for severe depression, some patients report persistent memory problems following ECT that impact their quality of life and their willingness to consent to further ECT. While cognitive training has been shown to improve memory performance in various conditions, this approach has never been applied to help patients regain their memory after ECT. In a double-blind study, we tested the efficacy of a new cognitive training program called Memory Training for ECT (Mem-ECT), specifically designed to target anterograde and retrograde memory that can be compromised following ECT. Fifty-nine patients with treatment-resistant depression scheduled to undergo ultra-brief right unilateral ECT were randomly assigned to either: (a) Mem-ECT, (b) active control comprised of nonspecific mental stimulation, or (c) treatment as usual. Participants were evaluated within one week prior to the start of ECT and then again within 2 weeks following the last ECT session. All three groups improved in global function, quality of life, depression, and self-reported memory abilities without significant group differences. While there was a decline in verbal delayed recall and mental status, there was no decline in general retrograde memory or autobiographical memory in any of the groups, with no significant memory or clinical benefit for the Mem-ECT or active control conditions compared to treatment as usual. While we report negative findings, these results continue to promote the much needed discussion on developing effective strategies to minimize the adverse memory side effects of ECT, in hopes it will make ECT a better and more easily tolerated treatment for patients with severe depression who need this therapeutic option.
authors.affiliation: Olin Neuropsychiatry Research Center, The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT, USA. Electronic address: jimmy.choi@hhchealth.org.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Choi
authors.affiliation: Columbia Psychiatry, College of Physicians and Surgeons, Columbia University Medical Center, NY, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, NY, USA; Division of Biostatistics, New York State Psychiatric Institute, NY, USA.
authors.forename: Yuanjia
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Division of Biostatistics, New York State Psychiatric Institute, NY, USA.
authors.forename: Tianshu
authors.initials: T
authors.lastname: Feng
authors.affiliation: Columbia Psychiatry, College of Physicians and Surgeons, Columbia University Medical Center, NY, USA; Division of Experimental Therapeutics, New York State Psychiatric Institute, 1051 Riverside Drive, NY 10032, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Prudic
mesh_terms: D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000628:therapy*; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology* / Q000534:rehabilitation*; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cognitive training; Depression; Electroconvulsive therapy; Memory