Improvement of Persistent Impairments in Executive Function and Attention Following ECT: a Case Control Longitudinal Study From Norway

 Out on PubMed, from researchers in Norway and Sweden, is this study:

Improvement of persistent impairments in executive functions and attention following electroconvulsive therapy in a case control longitudinal follow up study.

Hammar Å, Ronold EH, Spurkeland MA, Ueland R, Kessler U, Oedegaard KJ, Oltedal L.BMC Psychiatry. 2024 Nov 20;24(1):832. doi: 10.1186/s12888-024-06270-5.PMID: 39567961


The abstract is copied below:


Background: How cognition is influenced by electroconvulsive treatment (ECT) and major depressive disorder (MDD) is still debated. The development and etiology of neurocognitive impairment in MDD were examined by investigating the cognitive profile following ECT related to the state, scar, and trait perspectives, with the former predicting improvements parallel with depressive symptoms, while the two latter expected persisting impairments. Executive functions (EF) and attention are central to cognition and alterations in these functions could influence other domains like memory. The main aims of the present study were to examine the short and long-term effects of ECT on EF and attention in patients with major depressive disorder by exploiting the rapid antidepressant effect of this treatment.

Methods: A case-control longitudinal follow-up design was used to investigate the effects of unilateral brief-pulse ECT on EF and attention in patients with depression (n = 36) compared to untreated healthy controls (n = 16). EF and attention were measured pre-treatment, approximately two weeks, and six months post-treatment.

Results: The patient group showed significantly worse performance on most tests compared to healthy controls pre-treatment, and no short- or long-term worsening of EF and attention following ECT was found. Significant improvement was identified in patients' attention, processing speed and inhibition after ECT.

Conclusions: The present study showed that there was no cognitive worsening after ECT treatment. An improvement in several of the tests measuring inhibition, attention, and processing speed was parallel to symptom reduction, with the former showing associations to symptom change, suggesting state-related effects from improved mood. Still, the patient group performed significantly worse on most measures both pre-treatment and at the short and long-term follow-ups, indicating prevailing trait or scar effects on cognitive functions and potential lack of practice effects.

Clinical trial number: NCT04348825 (14.04.20).

The paper is here.
And from the text:







This is a carefully conducted and well-presented study of cognition in ECT. Despite some limitations, including small sample size, it provides very reassuring data about the cognitive tolerability profile of ECT. It also replicates well-known findings of the adverse effects of depression itself on cognitive functioning.
Kudos to our Norwegian and Swedish colleagues for this important contribution to the ECT cognition literature.


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