No Lasting Deficits in Executive Function After ECT: New Study From India

 Out on PubMed, from researchers in India, in JECT, is this study:


Effect of Modified Bifrontotemporal Electroconvulsive Therapy on Executive Function in Patients With Psychiatric Illness: A Longitudinal Observational Study.

Garg A, Pj P, Shirahatti B.J ECT. 2022 Feb 25. doi: 10.1097/YCT.0000000000000837. Online ahead of print.PMID: 35220364


The abstract is copied below:

Objective: The study was conducted to compare the pre-electroconvulsive therapy (ECT) and post-ECT status of the executive functions of patients and report any deficits found at long-term follow-up. The secondary objective of the study was to compare the performance at executive function tests after ECT with patient characteristics and ECT parameters.

Methodology: In a prospective longitudinal observational study, 50 patients in the age group of 18 to 65 years who were receiving modified bifrontotemporal ECT for the first time and admitted in psychiatry ward of a tertiary care hospital from July 2015 to June 2016 were assessed for executive functions using a neuropsychological battery consisting of digit span forward, digit span backward, spatial span forward, spatial span backward, phonemic verbal fluency test, semantic verbal fluency test, Stroop test, and Wisconsin Card Sorting Test, a day before ECT and then followed up at 3 and 6 months.

Results: Patients' score improved on all the tests of executive function at 3-month follow-up and was significant for some tests. Improvement was sustained for all the tests 6 months after ECT. Number of years of formal education of patients before illness significantly influenced patients' performance on most of the executive function tests after ECT. Younger age of the patient positively influenced patients' performance on digit span forward and backwards and semantic verbal fluency.

Conclusions: There are no executive function deficits 3 to 6 months after brief pulse modified ECT with bilateral electrode placement. A higher premorbid education level is associated with better performance on executive functions after ECT.

The article is here.

And from the text:




This is a reasonably conducted study, that, despite some methodological compromises (e.g."All 3 neuropsychological tests were conducted by the same author, and there was no interrater bias in the neuropsychological tests.") has quite believable results. ECT improved executive function at 3 and 6 months compared to baseline in this cohort of mostly young patients with schizophrenia. The fact that there is no immediate post-ECT time point is a shortcoming, so that we do not know about acute impairment. The description of the individual neuropsychological tests in the battery is excellent and instructive. I recommend a full read, ~ 15 minutes, to all those interested in neuropsych testing in ECT.

Comments

  1. William V McCallMarch 22, 2022 at 2:55 PM

    Dr. Kellner thank you for drawing attention to this topic. Executive function is integral to self-determination for our patients, and the findings of this study advance the idea that ECT is an enabling (not disabling) treatment for out patients
    William V McCall

    ReplyDelete

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