Esmée Verwijk1, Hannie C Comijs2, Rob M Kok1, Harm-Pieter Spaans1, Caroline E M Tielkes3, Erik J A Scherder4, Max L Stek2. 1. ECT Department, Clinical Center for the Elderly, Parnassia Psychiatric Institute, the Hague, the Netherlands. 2. GGZinGeest/VU University Medical Center, Amsterdam, the Netherlands. 3. Tergooiziekenhuizen, Blaricum/Hilversum, the Netherlands. 4. Department of Clinical Neuropsychology, VU University, Amsterdam, the Netherlands.
Abstract
BACKGROUND: It is generally assumed that the elderly patients are more vulnerable to cognitive side effects after electroconvulsive therapy (ECT) than younger depressed patients. The current study aims to evaluate the nature and extent of changes across multiple domains of neurocognitive functioning in a group of elderly depressed patients after ECT. METHODS: In this prospective naturalistic study, we included 42 depressed patients aged ≥55 years. Global cognitive function, memory, and executive function were assessed before ECT treatment and within one week (short-term post-ECT) and six months after ECT (long-term post-ECT). Associations between cognitive functioning and electrode placement, total number of treatment sessions, age, and the severity of depression at the time of cognitive measurement were studied. RESULTS: Our data offered no evidence of decline for any of the neurocognitive tests after ECT, given its power to detect the difference. Post-ECT improvement of neurocognitive functioning was statistically significant for the Mini-Mental State Examination, Visual Association Test, 10 Words Verbal Learning Test, and Expanded Mental Control Test. Effect sizes were medium to large. After six months, compared with post-ECT performance, statistically significant improvement was found only for the Trail Making Test-A and the Letter Fluency Test with small to medium effect sizes. CONCLUSIONS: In our severely depressed elderly patients, neurocognitive performance improved or did not change after ECT. Patients with poor cognitive function were not able to participate in neuropsychological assessment before ECT started. Consequently these results may not apply to patients with more severe cognitive impairment prior to the start of ECT.
BACKGROUND: It is generally assumed that the elderly patients are more vulnerable to cognitive side effects after electroconvulsive therapy (ECT) than younger depressedpatients. The current study aims to evaluate the nature and extent of changes across multiple domains of neurocognitive functioning in a group of elderly depressedpatients after ECT. METHODS: In this prospective naturalistic study, we included 42 depressedpatients aged ≥55 years. Global cognitive function, memory, and executive function were assessed before ECT treatment and within one week (short-term post-ECT) and six months after ECT (long-term post-ECT). Associations between cognitive functioning and electrode placement, total number of treatment sessions, age, and the severity of depression at the time of cognitive measurement were studied. RESULTS: Our data offered no evidence of decline for any of the neurocognitive tests after ECT, given its power to detect the difference. Post-ECT improvement of neurocognitive functioning was statistically significant for the Mini-Mental State Examination, Visual Association Test, 10 Words Verbal Learning Test, and Expanded Mental Control Test. Effect sizes were medium to large. After six months, compared with post-ECT performance, statistically significant improvement was found only for the Trail Making Test-A and the Letter Fluency Test with small to medium effect sizes. CONCLUSIONS: In our severely depressed elderly patients, neurocognitive performance improved or did not change after ECT. Patients with poor cognitive function were not able to participate in neuropsychological assessment before ECT started. Consequently these results may not apply to patients with more severe cognitive impairment prior to the start of ECT.
Authors: Shawn M McClintock; Jimmy Choi; Zhi-De Deng; Lawrence G Appelbaum; Andrew D Krystal; Sarah H Lisanby Journal: J ECT Date: 2014-06 Impact factor: 3.635
Authors: Joey P A J Verdijk; Julia C M Pottkämper; Esmée Verwijk; Guido A van Wingen; Michel J A M van Putten; Jeannette Hofmeijer; Jeroen A van Waarde Journal: Trials Date: 2022-04-18 Impact factor: 2.728
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
Authors: Ian M Anderson; R Hamish McAllister-Williams; Darragh Downey; Rebecca Elliott; Colleen Loo Journal: Psychol Med Date: 2020-02-27 Impact factor: 7.723