Antidepressant and cognitive effects of twice- versus three-times- weekly ECT

Lerer, Bernard; Shapira, Baruch; Calev, Avraham; Tubi, Nurith; Drexler, Heinz; Kindler, Seth; Lidsky, D.; Schwartz, Joseph E.

doi:10.1176/ajp.152.4.564

Cited by 102 publications

(5 citation statements)

References 30 publications

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“…It is now well established that certain ECT treatment factors are critically related to both the severity and type of cognitive side effects experienced by patients. For example, the use of higher electrical dose ( Ottosson, 1960 ; Sackeim et al, 1993 ; McCall et al, 2000 ; Quante et al, 2011 ), increased frequency of treatments ( Lerer et al, 1995 ), and choice of stimulus parameters, including use of sine wave stimulation ( Sackeim et al, 2007 ) and brief-pulse instead of “ultrabrief” pulse width stimulus ( Sackeim et al, 2008 ; Loo et al, 2014 ; Tor et al, in press), have been demonstrated to be associated with increased cognitive side effects. In addition, the choice of ECT electrode placements is important, as montages that minimize the degree of temporal lobe stimulation, including right unilateral (RUL), have been found beneficial for reducing memory side effects ( Sackeim et al, 1993 ; Sobin et al, 1995 ; Dunne and McLoughlin, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Predicting Retrograde Autobiographical Memory Changes Following Electroconvulsive Therapy: Relationships between Individual, Treatment, and Early Clinical Factors

Martin¹,

Gálvez²,

Loo³

2015

IJNPPY

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Background:Loss of personal memories experienced prior to receiving electroconvulsive therapy is common and distressing and in some patients can persist for many months following treatment. Improved understanding of the relationships between individual patient factors, electroconvulsive therapy treatment factors, and clinical indicators measured early in the electroconvulsive therapy course may help clinicians minimize these side effects through better management of the electroconvulsive therapy treatment approach. In this study we examined the associations between the above factors for predicting retrograde autobiographical memory changes following electroconvulsive therapy.Methods:Seventy-four depressed participants with major depressive disorder were administered electroconvulsive therapy 3 times per week using either a right unilateral or bitemporal electrode placement and brief or ultrabrief pulse width. Verbal fluency and retrograde autobiographical memory (assessed using the Columbia Autobiographical Memory Interview – Short Form) were tested at baseline and after the last electroconvulsive therapy treatment. Time to reorientation was measured immediately following the third and sixth electroconvulsive therapy treatments.Results:Results confirmed the utility of measuring time to reorientation early during the electroconvulsive therapy treatment course as a predictor of greater retrograde amnesia and the importance of assessing baseline cognitive status for identifying patients at greater risk for developing later side effects. With increased number of electroconvulsive therapy treatments, older age was associated with increased time to reorientation. Consistency of verbal fluency performance was moderately correlated with change in Columbia Autobiographical Memory Interview – Short Form scores following right unilateral electroconvulsive therapy.Conclusions:Electroconvulsive therapy treatment techniques associated with lesser cognitive side effects should be particularly considered for patients with lower baseline cognitive status or older age.

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Section: Introductionmentioning

confidence: 99%

Predicting Retrograde Autobiographical Memory Changes Following Electroconvulsive Therapy: Relationships between Individual, Treatment, and Early Clinical Factors

Martin¹,

Gálvez²,

Loo³

2015

IJNPPY

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“…Electroconvulsive therapy is a common physical therapy in the department of psychiatric diseases (Rey and Walter 1997 ), but the mechanism underlying the therapeutic effect of electric shock therapy is still unclear although it has definite therapeutic efficacy (Danese 2006 ). A majority of investigators have investigated the brain dysfunction secondary to ECT or MECT, but studies are mainly confined to imaging examinations and psychological examinations (Lerer et al 1995 ; Wengel et al 1998 ; Barnes et al 1997 ). The brain function is mainly evaluated by EEG.…”

Section: Discussionmentioning

confidence: 99%

Effects of modified electroconvulsive therapy on the electroencephalogram of schizophrenia patients

2016

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BackgroundThis study aimed to investigate the modified electroconvulsive therapy (MECT) on the electroencephalogram (EEG) of schizophrenia patients. A total of 26 schizophrenia patients who received MECT were recruited. EEG recording was initiated at 30 min before 1st and 6th MECT and terminated on the 2nd day. Images without artifacts were selected for the analysis of δ, θ, α1, α2 and β bands. The wave energy at each frequency, index of waves at different bands from the same lead, index of waves at the same band from different leads, time of epileptic discharge, time of resting state, and time to the stable EEG were determined and compared.ResultsThe energy of slow waves increased. α waves reduced, but θ waves increased in the frontotemporal area. The index of θ waves increased. After resting state, brainwaves first occurred in the frontal area. Significant difference was observed in the time to waves returning to normal (P = 0.05).ConclusionsAfter MECT, the θ waves in the same lead increases, and its energy also elevates; α wave in the frontotemporal area reduces; there is transient reduction in cerebral function during MECT. After electric resting state, brainwaves mainly occur in the frontal area, and the time to brainwaves returning to normal reduces over time after MECT.

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“…Per hospital protocol, if individuals experience cognitive impairment based on routine clinical evaluation with right unilateral or bilateral ECT during thrice a week sessions, ECT treatments may be performed twice a week ( 94 ). Cognitive impairment determined during routine clinical practice will be based on history and bedside clinical examination.…”

Section: Methods and Analysismentioning

confidence: 99%

Correlating electroconvulsive therapy response to electroencephalographic markers: Study protocol

et al. 2022

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IntroductionElectroconvulsive therapy (ECT) is an effective intervention for patients with major depressive disorder (MDD). Despite longstanding use, the underlying mechanisms of ECT are unknown, and there are no objective prognostic biomarkers that are routinely used for ECT response. Two electroencephalographic (EEG) markers, sleep slow waves and sleep spindles, could address these needs. Both sleep microstructure EEG markers are associated with synaptic plasticity, implicated in memory consolidation, and have reduced expression in depressed individuals. We hypothesize that ECT alleviates depression through enhanced expression of sleep slow waves and sleep spindles, thereby facilitating synaptic reconfiguration in pathologic neural circuits.MethodsCorrelating ECT Response to EEG Markers (CET-REM) is a single-center, prospective, observational investigation. Wireless wearable headbands with dry EEG electrodes will be utilized for at-home unattended sleep studies to allow calculation of quantitative measures of sleep slow waves (EEG SWA, 0.5–4 Hz power) and sleep spindles (density in number/minute). High-density EEG data will be acquired during ECT to quantify seizure markers.DiscussionThis innovative study focuses on the longitudinal relationships of sleep microstructure and ECT seizure markers over the treatment course. We anticipate that the results from this study will improve our understanding of ECT.

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Antidepressant and cognitive effects of twice- versus three-times- weekly ECT

Cited by 102 publications

References 30 publications

Predicting Retrograde Autobiographical Memory Changes Following Electroconvulsive Therapy: Relationships between Individual, Treatment, and Early Clinical Factors

Predicting Retrograde Autobiographical Memory Changes Following Electroconvulsive Therapy: Relationships between Individual, Treatment, and Early Clinical Factors

Effects of modified electroconvulsive therapy on the electroencephalogram of schizophrenia patients

Correlating electroconvulsive therapy response to electroencephalographic markers: Study protocol

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