Jasmien Obbels1, Kristof Vansteelandt2, Esmée Verwijk3, Annemieke Dols4, Filip Bouckaert5, Mardien L Oudega4, Mathieu Vandenbulcke6, Max Stek4, Pascal Sienaert2. 1. Academic Center for ECT and Neuromodulation (AcCENT) (JO, KV, FB, PS), University Psychiatric Center, KU Leuven-University of Leuven, Kortenberg, Belgium. Electronic address: jasmien.obbels@upckuleuven.be. 2. Academic Center for ECT and Neuromodulation (AcCENT) (JO, KV, FB, PS), University Psychiatric Center, KU Leuven-University of Leuven, Kortenberg, Belgium. 3. Department of Medical Psychology (EV), Neuropsychology Department, Amsterdam UMC Academic Medical Center, The Netherlands; Department of Psychology (EV), Brain & Cognition, University of Amsterdam, Amsterdam, The Netherlands; ECT Department (EV), Parnassia Psychiatric Institute, The Hague, The Netherlands. 4. Department of Old Age Psychiatry (AD, MLO, MS), GGZ inGeest/Amsterdam University/VU Medical Center, Amsterdam Public Health Research Institute, Amsterdam Neuroscience, Amsterdam, The Netherlands. 5. Academic Center for ECT and Neuromodulation (AcCENT) (JO, KV, FB, PS), University Psychiatric Center, KU Leuven-University of Leuven, Kortenberg, Belgium; Old-Age Psychiatry (FB, MV), University Psychiatric Center, KU Leuven-University of Leuven, Kortenberg, Belgium. 6. Old-Age Psychiatry (FB, MV), University Psychiatric Center, KU Leuven-University of Leuven, Kortenberg, Belgium.
Abstract
OBJECTIVE: There is ongoing concern about the impact of electroconvulsive therapy (ECT) on cognition in patients with late-life depression (LLD), especially in patients for whom pretreatment Mini-Mental State Exam (MMSE) scores are low. Our aim was to examine the evolution of cognitive effects of ECT, using the MMSE in a large group of patients with LLD. METHODS: One hundred nine patients aged 55 years and older with unipolar depression, referred for ECT, were included in our study. The MMSE was assessed before, during, immediately after, and 6 months after ECT. RESULTS: MMSE scores improved significantly during the course of ECT and remained stable during the 6-month period after ending ECT for the total group. In the group of patients with a low MMSE score (<24) at baseline, the MMSE score improved significantly during ECT, whereas in the group of patients with a normal MMSE score (≥24) at baseline, the score did not change significantly during ECT. In both groups, MMSE scores still increased slightly after ECT was discontinued. CONCLUSION: ECT does not cause deleterious cognitive effects, as measured with the MMSE, during and for 6 months after the ECT course in patients with LLD. In the event of a baseline cognitive impairment, MMSE scores tend to improve significantly during and for 6 months after the ECT course. The presence of pretreatment cognitive impairment should not lead clinicians to withhold ECT in older patients with severe depression.
OBJECTIVE: There is ongoing concern about the impact of electroconvulsive therapy (ECT) on cognition in patients with late-life depression (LLD), especially in patients for whom pretreatment Mini-Mental State Exam (MMSE) scores are low. Our aim was to examine the evolution of cognitive effects of ECT, using the MMSE in a large group of patients with LLD. METHODS: One hundred nine patients aged 55 years and older with unipolar depression, referred for ECT, were included in our study. The MMSE was assessed before, during, immediately after, and 6 months after ECT. RESULTS: MMSE scores improved significantly during the course of ECT and remained stable during the 6-month period after ending ECT for the total group. In the group of patients with a low MMSE score (<24) at baseline, the MMSE score improved significantly during ECT, whereas in the group of patients with a normal MMSE score (≥24) at baseline, the score did not change significantly during ECT. In both groups, MMSE scores still increased slightly after ECT was discontinued. CONCLUSION: ECT does not cause deleterious cognitive effects, as measured with the MMSE, during and for 6 months after the ECT course in patients with LLD. In the event of a baseline cognitive impairment, MMSE scores tend to improve significantly during and for 6 months after the ECT course. The presence of pretreatment cognitive impairment should not lead clinicians to withhold ECT in older patients with severe depression.
Authors: James Luccarelli; Brent P Forester; Mary Dooley; Regan E Patrick; David G Harper; Stephen J Seiner; Georgios Petrides; Martina Mueller; Michael E Henry Journal: Am J Geriatr Psychiatry Date: 2021-12-17 Impact factor: 7.996
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