Electroconvulsive therapy and cognitive performance from the Global ECT MRI Research Collaboration.

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Science

Background:

• The Global ECT MRI Research Collaboration (GEMRIC) has gathered extensive clinical and neuroimaging data from electroconvulsive therapy (ECT) patients worldwide.
• Previous GEMRIC research primarily focused on neuroimaging correlates of antidepressant response.
• Longitudinal cognitive data has also been collected across GEMRIC sites.

Purpose of the Study:

• To summarize existing GEMRIC cognitive data and propose recommendations for future ECT-imaging studies.
• To analyze longitudinal cognitive changes in patients undergoing ECT compared to healthy controls.
• To identify associations between demographic/ECT parameters and cognitive alterations.

Main Methods:

• Selection of cognitive measures for mega-analysis: Trail Making Test (TMT) Parts A and B, verbal fluency (category and letter), and verbal learning/memory percent retention.
• Longitudinal data analysis of pre-/post-ECT assessments in patients and healthy comparison (HC) subjects.
• Assessment of demographic and ECT parameters' impact on cognitive changes.

Main Results:

• An interaction between electrode placement and treatment number affected verbal fluency category (VFC), with higher treatment associated with decreased VFC performance in right unilateral placement.
• Percent retention showed a group effect, with lower performance in the HC group.
• No significant group effects or interactions were found for TMT-A, TMT-B, or VFL.

Conclusions:

• The current GEMRIC cognitive dataset has limitations, including a restricted range of neuropsychological domains assessed.
• Apart from the VFC and treatment number interaction, no significant ECT-mediated neurocognitive effects were observed.
• Recommendations for future ECT-imaging studies emphasize robust psychometrics and minimal participant burden for cognitive assessments.