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Transient Cognitive Impairment and White Matter Hyperintensities in Severely Depressed Older Patients Treated With Electroconvulsive Therapy
- Source :
- American Journal of Geriatric Psychiatry, 29(11), 1117-1128. Lippincott Williams and Wilkins, Wagenmakers, M J, Vansteelandt, K, van Exel, E, Postma, R, Schouws, S N T M, Obbels, J, Rhebergen, D, Bouckaert, F, Stek, M L, Barkhof, F, Beekman, A T F, Veltman, D J, Sienaert, P, Dols, A & Oudega, M L 2021, ' Transient Cognitive Impairment and White Matter Hyperintensities in Severely Depressed Older Patients Treated With Electroconvulsive Therapy ', American Journal of Geriatric Psychiatry, vol. 29, no. 11, pp. 1117-1128 . https://doi.org/10.1016/j.jagp.2020.12.028
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- BACKGROUND: Although electroconvulsive therapy (ECT) is a safe and effective treatment for patients with severe late life depression (LLD), transient cognitive impairment can be a reason to discontinue the treatment. The aim of the current study was to evaluate the association between structural brain characteristics and general cognitive function during and after ECT. METHODS: A total of 80 patients with LLD from the prospective naturalistic follow-up Mood Disorders in Elderly treated with Electroconvulsive Therapy study were examined. Magnetic resonance imaging scans were acquired before ECT. Overall brain morphology (white and grey matter) was evaluated using visual rating scales. Cognitive functioning before, during, and after ECT was measured using the Mini Mental State Examination (MMSE). A linear mixed-model analysis was performed to analyze the association between structural brain alterations and cognitive functioning over time. RESULTS: Patients with moderate to severe white matter hyperintensities (WMH) showed significantly lower MMSE scores than patients without severe WMH (F(1,75.54) = 5.42, p = 0.02) before, during, and post-ECT, however their trajectory of cognitive functioning was similar as no time × WMH interaction effect was observed (F(4,65.85) = 1.9, p = 0.25). Transient cognitive impairment was not associated with medial temporal or global cortical atrophy (MTA, GCA). CONCLUSION: All patients showed a significant drop in cognitive functioning during ECT, which however recovered above baseline levels post-ECT and remained stable until at least 6 months post-ECT, independently of severity of WMH, GCA, or MTA. Therefore, clinicians should not be reluctant to start or continue ECT in patients with severe structural brain alterations. ispartof: American Journal Of Geriatric Psychiatry vol:29 issue:11 pages:1117-1128 ispartof: location:England status: accepted
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
late life depression
Grey matter
behavioral disciplines and activities
Electroconvulsive therapy
Internal medicine
mental disorders
Humans
Medicine
Cognitive Dysfunction
Prospective Studies
Electroconvulsive Therapy
structural MRI
Aged
Mini–Mental State Examination
medicine.diagnostic_test
Depression
business.industry
Brain morphometry
transient cognitive impairment
Brain
Cognition
white matter hyperintensities
Late life depression
medicine.disease
White Matter
Hyperintensity
Psychiatry and Mental health
medicine.anatomical_structure
Mood disorders
Cardiology
severe depression
Geriatrics and Gerontology
business
Subjects
Details
- ISSN :
- 10647481
- Volume :
- 29
- Database :
- OpenAIRE
- Journal :
- The American Journal of Geriatric Psychiatry
- Accession number :
- edsair.doi.dedup.....c5f47155f1d11b91f936db5707cd1acf