Early shifts of emotional attention as a possible predictor of remission in patients with depression receiving ECT: Preliminary results of an eye-tracker study

Abstract

Background Electro-convulsive therapy (ECT) is one of the most effective treatment for treatment resistant depression (TRD) with remission rates of 87% [1] . Despite such a significant clinical effect generally observed after 6 to 20 sessions, ECT is also accompanied by major cognitive side effects and no markers of remission are available to help practitioners deciding to continue or not to deliver ECT sessions. Evidence suggests that early improvements in emotional processing, a commonly observed cognitive deficits in depression, can predict later clinical response to antidepressant [2] . Based on these studies, we hypothesized that early enhancement in emotional processing would predict remission in patients receiving ECT. Methods In an open pilot study, 30 patients with TRD receiving ECT will be enrolled. A free-viewing eye-tracking paradigm will be used to measure preferential attention to positive, negative or neutral faces. In this task patients will have to passively watch 2 pictures of faces (one neutral and one emotional face) presented during 3.5 sec on a computer screen. Eye-gaze patterns and time spend to the affective and to the neutral face will be assessed twice, one time at baseline and one time after the 6th ECT session. Severity of depression will be assessed using the MADRS at baseline, after the 6th and after the last ECT sessions. Results We report preliminary results in 8 patients. At the 6th ECT session, attention to happy faces was improved by 27% after 6 ECT treatments as compared to baseline in future remitters (MADRS Conclusion Early modification at free-viewing eye-tracking paradigm measuring emotional attention could be a predictive marker of remission to ECT in patients with TRD. Further investigation are needed to confirm this hypothesis.