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Objective cognitive performance associated with electroconvulsive therapy for depression: a systematic review and
Maria Semkovska1, Declan M McLoughlin
1Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, St. Patrick's University Hospital, Ireland.
Biological Psychiatry
|August 3, 2010
Summary
Electroconvulsive therapy (ECT) significantly impacts cognition short-term, with most cognitive deficits resolving within 15 days. Some cognitive functions even improve beyond baseline after ECT.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Psychology
Background:
- Electroconvulsive therapy (ECT) is a highly effective acute treatment for depression.
- ECT is associated with cognitive side effects, but their persistence and pattern require clarification.
Purpose of the Study:
- To quantify cognitive changes associated with ECT.
- To determine the pattern and progression of ECT-induced cognitive effects.
Main Methods:
- Systematic literature search across multiple databases (MEDLINE, EMBASE, etc.) through January 2009.
- Meta-analysis of within-subjects studies assessing cognition using standardized tests before and after ECT.
- Exploration of moderators like electrode placement and stimulus waveform.
Main Results:
- Meta-analysis included 84 studies with 2981 patients, examining 24 cognitive variables.
- Significant cognitive performance decreases were observed 0-3 days post-ECT in 72% of variables.
- No negative effects were observed after 15 days; 57% of variables showed improvement beyond baseline.
Conclusions:
- ECT-associated cognitive abnormalities are primarily transient, mainly occurring within the first 3 days post-ECT.
- Cognitive function generally recovers to pretreatment levels.
- Processing speed, working memory, anterograde memory, and executive functions may improve beyond baseline after 15 days.
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