Unravelling Autobiographical Retrograde Amnesia Following Bitemporal Electroconvulsive Therapy: Effect of Treatment versus Effect of Time

Abstract

Objective: To reliably quantify the autobiographical retrograde amnesia directly attributable to the effect of electroconvulsive therapy (ECT) independent from normal and depression-associated changes in autobiographical memory consistency. Method: By use of retrospective case-control study design, 19 severely depressed inpatients never treated with ECT who received pharmacotherapy (noECT group) were individually matched to similarly depressed 19 patients treated with standard, bitemporal electrode placement, ECT (B-ECT). The two groups were compared at Pre-Treatment, at PostTreatment and at three months Follow-Up on their performance on the Semantic, Episodic-Extended and Episodic-Specific Components of the Columbia Autobiographical Memory Interview-Short Form (CAMI-SF). Effects of treatment group and time on the three components were tested with 2 × 3 repeated-measures analyses of variance. Depression severity, assessed using the Hamilton Depression Rating Scale, was investigated as possible covariate. To explore the results' clinical significance, individual CAMI-SF performances were compared to available normative data. Results: At Pre-Treatment, the two groups were comparable on all three CAMI-SF components. In both groups, a significant effect of time explained decreased performance at PostTreatment and Follow-Up on all components (p-values < 0.0001). No significant effect of treatment was observed on the Semantic and Episodic-Extended components (p > 0.16). The B-ECT retrieval consistency on the EpisodicSpecific component was significantly worse at both Post-Treatment (p = 0.009) and Follow-Up (p = 0.012) relative to the noECT group. Ratios of im- paired retrieval consistency were higher in the B-ECT group than in the noECT group at Post-Treatment only. On individual level, bitemporal ECT was associated with a clinically significant decrease in Episodic-Specific autobiographical memory recall at Post-Treatment in 37% of participants and, for about 26%, this specific impairment persisted for at least three months after end of treatment. Depression severity did not influence observed results. Conclusion: ECT-associated autobiographical amnesia is limited to specific personal episodes, does not affect all patients and is reversible for some.

Right unilateral electroconvulsive therapy does not cause more cognitive impairment than pharmacologic treatment in treatment‐resistant bipolar depression: A 6‐month randomized controlled trial follow‐up study

“…Semkovska and colleagues published a study showing significant large decreases in retrieval consistency in healthy volunteers, but the results are not directly comparable to ours, as an alternative scoring system for the Columbia Autobiographical Memory Interview‐Short Form (CAMI‐SF) was used . Semkovska and O'Grady also compared pharmacotherapy with bitemporal ECT using the CAMI‐SF . Due to the aforementioned difference in the scoring system, and different electrode placement during ECT, it is hard to make direct comparisons to our study.…”

Pharmacological interventions to diminish cognitive side effects of electroconvulsive therapy: A systematic review and meta‐analysis

“…WAIS‐IV backward numbers), autobiographical memory (e.g. Columbia Autobiographical Memory Interview, given an improved new scoring system 90 , 91 , 92 ), processing speed (e.g. STROOP) and subjective memory (e.g.…”

Cognitive warfare

“…The temporary or persistent disruptions caused by controlled traumatic events can be characterised as induced dissociative states, featuring functional retrograde amnesia (i.e. psychogenic amnesia) [9,24,55,114], and detachment of self from the world or the alternating emergence of distinct personalities [22,58,120,160,175]. In this line, a large body of scientific research has shown a learned helplessness phenomenon appearing in specific uncontrollable adverse events [3,124,173].…”