Neural Mechanisms and Cognitive Outcomes Of Electroconvulsive Therapy: A Transdiagnostic Approach

Abstract

Introduction. Electroconvulsive therapy (ECT) is an effective treatment for severe mental health disorders (e.g., depression, psychosis). However, cognitive side effects and neural mechanisms underlying its therapeutic effect are not well understood. This study aims to probe the mechanisms of ECT using transcranial magnetic stimulation (TMS) and investigate cognitive outcomes in a diverse psychiatric population. Methods. Sixteen individuals receiving ECT completed three assessments (baseline/72-hrs post-/1-month post-ECT). Clinical symptoms were assessed and cognition was measured with the Montreal Cognitive Assessment (MoCA) and ElectroConvulsive therapy Cognitive Assessment (ECCA). Nine of those individuals underwent TMS to probe cortical inhibition and excitation. Results. Clinical symptoms significantly improved following ECT. MoCA scores significantly declined 72-hrs post-ECT, while ECCA scores were unchanged. Cortical inhibition significantly increased post-ECT and was correlated with cognitive and clinical changes. Conclusion. Our findings suggest that cortical inhibition is involved in the mechanisms of ECT and potentially linked to clinical and cognitive outcomes. 2.5.1 Clinical Assessments...……………...………..……………21 2.5.2 Main Clinical Outcome.……………………………….