BACKGROUND: Neurocognitive functioning is well known to be affected after ECT. However quantified data about the severity of the cognitive impairment after ultrabrief pulse and brief pulse ECT are limited, which makes it hard to judge its clinical relevance. METHODS: To review all prospective studies using right unilateral (ultra) brief pulse index electroconvulsive therapy published up until February 2011 which used at least one instrument for cognitive assessment before and after ECT. The severity and persistence of neurocognitive side effects immediately (one to seven days post ECT), between one and six months and after six months post ECT were assessed by calculating effect sizes using Cohen's d. RESULTS: Ten studies fulfilled the inclusion criteria and provided detailed information to compute effect sizes. The results indicate loss of autobiographical memory and impairment of verbal fluency, anterograde verbal and non-verbal memory immediately after brief pulse RUL ECT. To a lesser extent impairment of working memory and reduced speed of processing is found. Autobiographical memory is the only domain still being impaired between one and six months post ECT, but improved in this period. Verbal fluency normalized to baseline performance between one and six months post ECT whereas anterograde verbal and non-verbal memory normalized or even improved. Speed of processing improved within six months after ECT. Long-term data on these cognitive domains were not available. Based on two of the ten included studies the results suggest that ultrabrief pulse RUL ECT causes less decline in autobiographical and anterograde memory after ECT than brief pulse RUL ECT. LIMITATIONS: This review may be limited because of the small number of included studies and due to unreliable effect sizes. Furthermore, few data were available for non-memory domains and cognitive functioning after six months. CONCLUSIONS: Loss of autobiographical memory is still present between one and six months after unilateral brief pulse ECT. Ultrabrief pulse RUL ECT shows less decline in autobiographical memory. Other neurocognitive impairments after brief pulse RUL ECT seem to be transient.
BACKGROUND: Neurocognitive functioning is well known to be affected after ECT. However quantified data about the severity of the cognitive impairment after ultrabrief pulse and brief pulse ECT are limited, which makes it hard to judge its clinical relevance. METHODS: To review all prospective studies using right unilateral (ultra) brief pulse index electroconvulsive therapy published up until February 2011 which used at least one instrument for cognitive assessment before and after ECT. The severity and persistence of neurocognitive side effects immediately (one to seven days post ECT), between one and six months and after six months post ECT were assessed by calculating effect sizes using Cohen's d. RESULTS: Ten studies fulfilled the inclusion criteria and provided detailed information to compute effect sizes. The results indicate loss of autobiographical memory and impairment of verbal fluency, anterograde verbal and non-verbal memory immediately after brief pulse RUL ECT. To a lesser extent impairment of working memory and reduced speed of processing is found. Autobiographical memory is the only domain still being impaired between one and six months post ECT, but improved in this period. Verbal fluency normalized to baseline performance between one and six months post ECT whereas anterograde verbal and non-verbal memory normalized or even improved. Speed of processing improved within six months after ECT. Long-term data on these cognitive domains were not available. Based on two of the ten included studies the results suggest that ultrabrief pulse RUL ECT causes less decline in autobiographical and anterograde memory after ECT than brief pulse RUL ECT. LIMITATIONS: This review may be limited because of the small number of included studies and due to unreliable effect sizes. Furthermore, few data were available for non-memory domains and cognitive functioning after six months. CONCLUSIONS: Loss of autobiographical memory is still present between one and six months after unilateral brief pulse ECT. Ultrabrief pulse RUL ECT shows less decline in autobiographical memory. Other neurocognitive impairments after brief pulse RUL ECT seem to be transient.
Authors: Megha M Vasavada; Amber M Leaver; Stephanie Njau; Shantanu H Joshi; Linda Ercoli; Gerhard Hellemann; Katherine L Narr; Randall Espinoza Journal: J ECT Date: 2017-12 Impact factor: 3.635
Authors: Roumen V Milev; Peter Giacobbe; Sidney H Kennedy; Daniel M Blumberger; Zafiris J Daskalakis; Jonathan Downar; Mandana Modirrousta; Simon Patry; Fidel Vila-Rodriguez; Raymond W Lam; Glenda M MacQueen; Sagar V Parikh; Arun V Ravindran Journal: Can J Psychiatry Date: 2016-08-02 Impact factor: 4.356
Authors: Aida de Arriba-Arnau; Virginia Soria; Neus Salvat-Pujol; José M Menchón; Mikel Urretavizcaya Journal: Eur Arch Psychiatry Clin Neurosci Date: 2019-12-13 Impact factor: 5.270
Authors: Sarah H Lisanby; Shawn M McClintock; William V McCall; Rebecca G Knapp; C Munro Cullum; Martina Mueller; Zhi-De Deng; Abeba A Teklehaimanot; Matthew V Rudorfer; Elisabeth Bernhardt; George Alexopoulos; Samuel H Bailine; Mimi C Briggs; Emma T Geduldig; Robert M Greenberg; Mustafa M Husain; Styliani Kaliora; Vassilios Latoussakis; Lauren S Liebman; Georgios Petrides; Joan Prudic; Peter B Rosenquist; Shirlene Sampson; Kristen G Tobias; Richard D Weiner; Robert C Young; Charles H Kellner Journal: Am J Geriatr Psychiatry Date: 2021-05-17 Impact factor: 4.105