Short-Term, Long-term Effects of ECT on Cognitive Functioning

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Electroconvulsive therapy resulted in decreases in the depression scores between baseline and after treatment and baseline and follow-up.
Electroconvulsive therapy resulted in decreases in the depression scores between baseline and after treatment and baseline and follow-up.

For patients with depressive disorders, bilateral electroconvulsive therapy (ECT) has short-term negative cognitive effects, but functioning recovers after 6 months, according to results published in the Journal of Affective Disorders.

The study included participants with depression (n=48) and healthy control patients (n=19). Each participant underwent cognitive tests, including tests of working memory, verbal fluency, visuospatial abilities, verbal/visual memory, learning, processing speed, inhibition, attention, task-switching, and premorbid IQ. Participants underwent cognitive assessments at baseline (n=43), after 10 ECT sessions (posttreatment, n=39), and 6 months after the tenth ECT session (follow-up, n=25). Healthy control patients underwent cognitive assessment at baseline, and again after 5 weeks.

The researchers observed a global significant interaction effect between time and cognitive test in their multivariate mixed model (F=14.08; P <.001), which indicated that ECT had different effects over time on different cognitive variables.

Participants with depression had adverse effects on verbal memory and learning and verbal fluency posttreatment. However, after 6 months of follow-up, participants with depression showed significant improvement from their posttreatment scores, indicating that the effect was not permanent.

The results indicated that ECT did have a significant effect on depression scores, with significant decreases seen between baseline and posttreatment and baseline and follow-up (both P <.001).

"[L]ong term...no negative effects were seen compared to baseline cognitive functioning. These results might reduce the reluctance in some patients and practitioners to consider bilateral ECT as a safe and effective treatment for refractory depression," the researchers wrote.

Reference

Nuninga JO, Claessens TFI, Somers M, et al. Immediate and long-term effects of bilateral electroconvulsive therapy on cognitive functioning in patients with a depressive disorder. J Affect Disord. 2018;238:659-665.

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