Clinically insubstantial cognitive side effects of bitemporal electroconvulsive therapy at 0.5 msec pulse width

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Medicine

Background:

• Cognitive side effects are a concern with electroconvulsive therapy (ECT).
• Previous studies utilized ECT stimuli with pulse widths of at least 1 msec.

Purpose of the Study:

• To measure cognitive side effects of bitemporal ECT using stimuli of 0.5 msec pulse width and 900 mA.
• To compare cognitive outcomes with previous ECT studies.

Main Methods:

• 15 patients aged 45 and older received 6 bitemporal ECT sessions.
• Mini-Mental State Exam (MMSE) and Hamilton Rating Scale for Depression (HRSD-21) were administered before and after ECT.
• Stimuli used were 0.5 msec pulse width at 900 mA.

Main Results:

• MMSE scores remained high post-ECT (mean 28.53) with no significant change from pre-ECT scores (mean 29).
• HRSD-21 scores significantly decreased from a mean of 27.5 to 16.3, indicating improved depressive symptoms.
• Post-ECT MMSE scores were higher than those reported in studies using wider pulse widths.

Conclusions:

• Bitemporal ECT with 0.5 msec pulse width and 900 mA stimuli did not decrease cognitive function (MMSE).
• This ECT parameter is associated with clinically insubstantial cognitive side effects.
• These findings suggest that 0.5 msec pulse width ECT is more desirable than wider pulse widths for maintaining efficacy with fewer cognitive side effects.