Electroconvulsive therapy related autobiographical amnesia: a review and case report

Abstract

Introduction: While short-term cognitive impairment following electro-convulsive therapy (ECT) is well described and acknowledged, the relationship between ECT and persistent memory impairment, particularly of autobiographical memory, has been controversial. Methods:We describe the case of a 70 year old consultant neurophysiologist, AW, who developed prominent, selective autobiographical memory loss following two courses of ECT for treatmentresistant depression.Results: His performance on standard measures of IQ, semantic and episodic memory, executive function and mood was normal, while he performed significantly below controls on measures of episodic autobiographical memory. Conclusions:Explanations in terms of mood-related memory loss and somatoform disorder appear unlikely. We relate AW's autobiographical memory impairment, following his ECT, to reports of similar autobiographical memory impairment occurring in the context of epilepsy, and emphasise the importance of using sensitive approaches to AbM assessment.

Response to the Royal College of Psychiatrists’ critique of our audit of ECT usage

“…To achieve accreditation, a team must meet 100% of type 1 standards' (ECTAS, 2020). b In line with those suggested by Robertson and Pryor (2006) and Lomas et al (2021).…”

Systems consolidation, transformation and reorganization: Multiple Trace Theory, Trace Transformation Theory and their Competitors

“…Compromised hippocampal function led to a reduction in episodic aspects of recent and remote memories, whether for events or for environments, across the lifespan, with relative sparing of semantic or schematic aspects. This pattern of impoverished contextual details specific to an episode or location, with retention of general, non-specific information was observed in patients with extensive hippocampal damage whether caused by excisions or trauma (Sekeres et al, 2018;Wincour & Moscovitch, 2011), by infection by herpes simplex (Fujii et al, 2019) or by autoimmune disorders (Argyropoulos & Butler, 2020;Argyropoulos et al, 2019;Lad et al, 2019;Miller et al, 2020), by dementia (Piolino et al, 2009), by amnestic mild cognitive impairment (Murphy et al, 2008) or atrophy and dysfunction in normal aging (Levine et al, 2002;Viard et al, 2007), by accelerated long term forgetting and epilepsy (Butler & Zeman, 2008), by electroconvulsive therapy (ECT, Lomas et al, 2021) and by psychiatric disorders such as depression (Söderlund et al, 2014;Williams, et al, 2007) and schizophrenia (McLeod et al, 2006;Herold et al 2015).…”

Anesthetic Influence on Electroconvulsive Therapy: A Comprehensive Review

“…However, although the short-term cognitive impairment of ECT is well established, the relationship between ECT and persistent memory impairment, especially autobiographical memory, remains controversial. 98 Patients’ memory status prior to treatment and the time of assessment after ECT treatment have an impact on the results of the assessment of autobiographical memory. 99 Therefore, the evaluation methods need to be refined to further determine the effect of ECT on autobiographical memory.…”