Objective cognitive performance associated with electroconvulsive therapy for depression: a systematic review and meta-analysis.

Hdl Handle:
http://hdl.handle.net/10147/128713
Title:
Objective cognitive performance associated with electroconvulsive therapy for depression: a systematic review and meta-analysis.
Authors:
Semkovska, Maria; McLoughlin, Declan M
Affiliation:
Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, St. Patrick's University Hospital, Ireland.
Citation:
Objective cognitive performance associated with electroconvulsive therapy for depression: a systematic review and meta-analysis. 2010, 68 (6):568-77 Biol. Psychiatry
Journal:
Biological psychiatry
Issue Date:
15-Sep-2010
URI:
http://hdl.handle.net/10147/128713
DOI:
10.1016/j.biopsych.2010.06.009
PubMed ID:
20673880
Additional Links:
10.1016/j.biopsych.2010.06.009
Abstract:
Electroconvulsive therapy (ECT) is the most acutely effective treatment for depression, but is limited by cognitive side effects. However, research on their persistence, severity, and pattern is inconsistent. We aimed to quantify ECT-associated cognitive changes, specify their pattern, and determine progression.; MEDLINE, EMBASE, PsycArticles, PsychINFO, PsychLIT, and reference lists were systematically searched through January 2009. We included all independent, within-subjects design studies of depressed patients receiving ECT where cognition was assessed using standardized tests. Main outcome was change in performance after ECT relative to pretreatment scores with respect to delay between finishing ECT and cognitive testing. We explored potential moderators' influence, e.g., electrode placement, stimulus waveform.; Twenty-four cognitive variables (84 studies, 2981 patients) were meta-analyzed. No standardized retrograde amnesia tests were identified. Significant decreases in cognitive performance were observed 0 to 3 days after ECT in 72% of variables: effect sizes (ES) ranging from -1.10 (95% confidence interval [CI], -1.53 to -.67) to -.21 (95% CI, -.40 to .01). Four to 15 days post-ECT, all but one CI included zero or showed positive ES. No negative ES were observed after 15 days, with 57% of variables showing positive ES, ranging from .35 (95% CI, .07-.63) to .75 (95% CI, .43-1.08). Moderators did not influence cognitive outcomes after 3 days post-ECT.; Cognitive abnormalities associated with ECT are mainly limited to the first 3 days posttreatment. Pretreatment functioning levels are subsequently recovered. After 15 days, processing speed, working memory, anterograde memory, and some aspects of executive function improve beyond baseline levels.
Item Type:
Article
Language:
en
MeSH:
Cognition; Depressive Disorder, Major; Electroconvulsive Therapy; Humans; Neuropsychological Tests; Psychomotor Performance
ISSN:
1873-2402

Full metadata record

DC FieldValue Language
dc.contributor.authorSemkovska, Mariaen
dc.contributor.authorMcLoughlin, Declan Men
dc.date.accessioned2011-04-27T09:02:37Z-
dc.date.available2011-04-27T09:02:37Z-
dc.date.issued2010-09-15-
dc.identifier.citationObjective cognitive performance associated with electroconvulsive therapy for depression: a systematic review and meta-analysis. 2010, 68 (6):568-77 Biol. Psychiatryen
dc.identifier.issn1873-2402-
dc.identifier.pmid20673880-
dc.identifier.doi10.1016/j.biopsych.2010.06.009-
dc.identifier.urihttp://hdl.handle.net/10147/128713-
dc.description.abstractElectroconvulsive therapy (ECT) is the most acutely effective treatment for depression, but is limited by cognitive side effects. However, research on their persistence, severity, and pattern is inconsistent. We aimed to quantify ECT-associated cognitive changes, specify their pattern, and determine progression.-
dc.description.abstractMEDLINE, EMBASE, PsycArticles, PsychINFO, PsychLIT, and reference lists were systematically searched through January 2009. We included all independent, within-subjects design studies of depressed patients receiving ECT where cognition was assessed using standardized tests. Main outcome was change in performance after ECT relative to pretreatment scores with respect to delay between finishing ECT and cognitive testing. We explored potential moderators' influence, e.g., electrode placement, stimulus waveform.-
dc.description.abstractTwenty-four cognitive variables (84 studies, 2981 patients) were meta-analyzed. No standardized retrograde amnesia tests were identified. Significant decreases in cognitive performance were observed 0 to 3 days after ECT in 72% of variables: effect sizes (ES) ranging from -1.10 (95% confidence interval [CI], -1.53 to -.67) to -.21 (95% CI, -.40 to .01). Four to 15 days post-ECT, all but one CI included zero or showed positive ES. No negative ES were observed after 15 days, with 57% of variables showing positive ES, ranging from .35 (95% CI, .07-.63) to .75 (95% CI, .43-1.08). Moderators did not influence cognitive outcomes after 3 days post-ECT.-
dc.description.abstractCognitive abnormalities associated with ECT are mainly limited to the first 3 days posttreatment. Pretreatment functioning levels are subsequently recovered. After 15 days, processing speed, working memory, anterograde memory, and some aspects of executive function improve beyond baseline levels.-
dc.language.isoenen
dc.relation.url10.1016/j.biopsych.2010.06.009en
dc.subject.meshCognition-
dc.subject.meshDepressive Disorder, Major-
dc.subject.meshElectroconvulsive Therapy-
dc.subject.meshHumans-
dc.subject.meshNeuropsychological Tests-
dc.subject.meshPsychomotor Performance-
dc.titleObjective cognitive performance associated with electroconvulsive therapy for depression: a systematic review and meta-analysis.en
dc.typeArticleen
dc.contributor.departmentDepartment of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, St. Patrick's University Hospital, Ireland.en
dc.identifier.journalBiological psychiatryen
dc.description.provinceLeinster-
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