Subjective and objective cognitive side effects of electroconvulsive therapy in depression

Abstract

Background Treatment-resistant depressive disorder is inter alia characterized by cognitive impairments in memory, attention, and executive functions (EF) and can be treated with Electroconvulsive Therapy (ECT), which provides rapid symptom relief in 70% of the patients. So far research focused on the detection of objective memory impairments, whereas changes in subjective measures or other cognitive domains such as attention and EF were barely assessed. Furthermore, a neuropsychological test battery, tailored for the use in depressed patients who are undergoing ECT, is still lacking. Method Subjective and objective performance in attention, EF and memory were assessed in 24 patients with major depression using a novel neurocognitive test battery (Cognitive-Functions-Dementia, CFD) and a modified version of the “Mental Ability Questionnaire” (ModFLei) before and immediately after ECT. Results We found significant improvements in the recognition of verbal information (memory task) and a trend towards a decrease in lexical word fluency. Subjective memory functioning improved significantly, whereas a trend improvement of attention and EF as well as subjective global cognitive functioning could be observed. Conclusion and Outlook These findings support the cognitive safety of ECT and contradict the often-reported memory impairments after ECT, however, in a small sample size. Increasing our knowledge on a broad range of cognitive functions will allow us to develop specific therapeutic tools to counteract cognitive impairments in this patient group. Future research should investigate these questions in larger sample sizes and over a longer period of time.