What Type of Cognitive Testing Should Be Part of Routine Electroconvulsive Therapy Practice?

Several decades of research have yielded much information on the cognitive effects of electroconvulsive therapy (ECT) and have informed ECT technical factors such as electrode placement, stimulus dosing, and stimulus parameters. However, the question of what type of cognitive testing should be part of routine ECT practice has not been definitively clarified. The author reviews the recommendations, or lack thereof, in several published ECT guidelines and discusses the purposes that cognitive testing during ECT should serve and difficulties that most ECT services would encounter with intensive testing schedules. Practical utility of formal cognitive testing during and after ECT has not been satisfactorily demonstrated in ECT research. In addition, several key aspects of testing, such as cognitive domain to be tested, specific tests to be used, personnel to do the testing, time points of testing, and exactly how the test results will be interpreted and used have yet to be determined with precision. It is suggested that research efforts be undertaken to address these large gaps in ECT practice.