Neuropsychology and ECT: past and future research trends.

Past research focused on characterizing the cognitive deficits caused by ECT, understanding their causes, and defining ways of ameliorating the deficits. Future research includes the following recommendations. IN CHARACTERIZING THE DEFICITS: more accurately defining the time course to recovery; finding out whether specific memory tasks and specific patients show long-lasting effects; and defining specific components of memory and non-memory deficits (e.g., associative memory, incidental everyday memory, inattention). IN UNDERSTANDING THE CAUSES: determining whether seizure activity in certain brain structures is associated with specific cognitive deficits; finding out in which ways electric dose, electrode placement, seizure duration, and seizure threshold interact in causing the deficits; evaluating the effects of mediating variables such as blood pressure rise; and assessing the influence of background variables such as age, sex, and brain abnormality. IN AMELIORATING THE DEFICITS: continuing the search for effective medication; defining ways of reducing the number of treatments (twice weekly ECT, caffeine or thyroxine modified treatment); and manipulating dose in relation to electrode placement.