{"id":496,"date":"2024-01-22T09:36:02","date_gmt":"2024-01-22T09:36:02","guid":{"rendered":"https:\/\/dutchectconsortium.nl\/?p=496"},"modified":"2024-12-04T18:54:14","modified_gmt":"2024-12-04T18:54:14","slug":"predictors-of-cognitive-side-effects","status":"publish","type":"post","link":"https:\/\/dutchectconsortium.nl\/index.php\/2024\/01\/22\/predictors-of-cognitive-side-effects\/","title":{"rendered":"Predictors of cognitive side-effects"},"content":{"rendered":"<style>.kb-row-layout-id496_dbc910-ec > .kt-row-column-wrap{align-content:start;}:where(.kb-row-layout-id496_dbc910-ec > .kt-row-column-wrap) > .wp-block-kadence-column{justify-content:start;}.kb-row-layout-id496_dbc910-ec > .kt-row-column-wrap{column-gap:var(--global-kb-gap-md, 2rem);row-gap:var(--global-kb-gap-md, 2rem);max-width:900px;padding-top:25px;padding-bottom:85px;grid-template-columns:minmax(0, 1fr);}.kb-row-layout-id496_dbc910-ec{background-color:#fff;}.kb-row-layout-id496_dbc910-ec > .kt-row-layout-overlay{opacity:0.30;}.kb-row-layout-id496_dbc910-ec .kt-row-layout-bottom-sep{height:100px;}.kb-row-layout-id496_dbc910-ec .kt-row-layout-bottom-sep svg{width:100%;}.kb-row-layout-id496_dbc910-ec .kt-row-layout-bottom-sep svg{fill:#ffffff!important;}@media all and (max-width: 1024px){.kb-row-layout-id496_dbc910-ec > .kt-row-column-wrap{grid-template-columns:repeat(2, minmax(0, 1fr));}}@media all and (max-width: 1024px){.kb-row-layout-id496_dbc910-ec .kt-row-layout-bottom-sep{height:px;}}@media all and (max-width: 1024px){.kb-row-layout-id496_dbc910-ec .kt-row-layout-bottom-sep svg{width:%;}}@media all and (max-width: 767px){.kb-row-layout-id496_dbc910-ec > .kt-row-column-wrap{grid-template-columns:minmax(0, 1fr);}.kb-row-layout-id496_dbc910-ec .kt-row-layout-bottom-sep{height:px;}.kb-row-layout-id496_dbc910-ec .kt-row-layout-bottom-sep svg{width:%;}}<\/style><div class=\"kb-row-layout-wrap kb-row-layout-id496_dbc910-ec alignnone kt-row-has-bg wp-block-kadence-rowlayout\"><div class=\"kt-row-column-wrap kt-has-2-columns kt-row-layout-row kt-tab-layout-inherit kt-mobile-layout-row kt-row-valign-top kb-theme-content-width\">\n<style>.kadence-column496_0d9ae0-66 > .kt-inside-inner-col,.kadence-column496_0d9ae0-66 > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column496_0d9ae0-66 > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column496_0d9ae0-66{position:relative;}<\/style>\n<div class=\"wp-block-kadence-column kadence-column496_0d9ae0-66 inner-column-2\"><div class=\"kt-inside-inner-col\">\n<p class=\"has-larger-font-size wp-block-paragraph\">Pre-treatment predictors of cognitive side-effects after treatment with electroconvulsive therapy in patients with depression: A multicenter study<\/p>\n\n\n\n<p class=\"has-small-font-size wp-block-paragraph\">D. Loef, P.F.P. van Eijndhoven, E. van den Munckhof, A.W. Hoogendoorn, R. Manten, H.P. Spaans, I. Tendolkar, B.P.F. Rutten, J.O. Nuninga, M. Somers, E. van Dellen, E. van Exel, S.N.T.M. Schouws, A. Dols*, E. Verwijk*<br>* Shared supervision<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-regular-font-size\" id=\"st0010\" style=\"font-style:normal;font-weight:100;text-transform:none\"><strong>Background<\/strong>: Electroconvulsive therapy&nbsp;(ECT) is a highly effective&nbsp;treatment&nbsp;for&nbsp;major depressive episodes&nbsp;(MDE). However, ECT-induced cognitive side-effects remain a concern. Identification of pre-treatment predictors that contribute to these side-effects remain unclear. We examined cognitive performance and individual cognitive profiles over time (up to six months) following ECT and investigated possible pre-treatment clinical and demographic predictors of cognitive decline shortly after ECT.<br><strong>Methods<\/strong>: 634 patients with MDE from five sites were included with recruitment periods between 2001 and 2020. Linear mixed models were used to examine how cognitive performance, assessed with an extensive&nbsp;neuropsychological test&nbsp;battery, evolved over time following ECT. Next, possible pre-treatment predictors of cognitive side-effects directly after ECT were examined using&nbsp;linear regression.<br><strong>Results<\/strong>: Directly after ECT, only verbal fluency (animal and letter;&nbsp;<em>p<\/em>&nbsp;&lt;&nbsp;0.0001; Cohen&#8217;s&nbsp;<em>d<\/em>: \u22120.25 and \u22120.29 respectively) and verbal recall (<em>p<\/em>&nbsp;&lt;&nbsp;0.0001; Cohen&#8217;s&nbsp;<em>d<\/em>: \u22120.26) significantly declined. However, during three and six months of follow-up, cognitive performance across all domains significantly improved, even outperforming baseline levels. No other pre-treatment factor than a younger age predicted a larger deterioration in cognitive performance shortly after ECT.<br><strong>Limitations<\/strong>: There was a substantial amount of missing data especially at 6&nbsp;months follow-up.<br><strong>Conclusions<\/strong>: Our findings show that verbal fluency and memory retention are temporarily affected immediately after ECT. Younger patients may be more susceptible to experiencing these acute cognitive side-effects, which seems to be mostly due to a more intact cognitive functioning prior to ECT. These findings could contribute to decision-making regarding treatment selection,&nbsp;psychoeducation, and guidance during an ECT course.<\/h3>\n\n\n\n<div class=\"wp-block-file\"><a id=\"wp-block-file--media-7a5457eb-c7a1-42c9-b75f-e4ad2820a06a\" href=\"https:\/\/dutchectconsortium.nl\/wp-content\/uploads\/2024\/01\/1-s2.0-S0165032724000594-main.pdf\"><strong>Click here to download the article<\/strong><\/a><a href=\"https:\/\/dutchectconsortium.nl\/wp-content\/uploads\/2024\/01\/1-s2.0-S0165032724000594-main.pdf\" class=\"wp-block-file__button wp-element-button\" download aria-describedby=\"wp-block-file--media-7a5457eb-c7a1-42c9-b75f-e4ad2820a06a\">Download<\/a><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"Abstract\nIntroduction: Major depressive disorder (MDD) is a common psychiatric disorder. Despite several treatment options, a subgroup of patients will not respond to\nthe commonly used antidepressant treatments and thus express treatment resistance (TRD). TRD can be quantified with the Dutch Measure for Treatment Resistance in Depression (DM-TRD). Electroconvulsive therapy (ECT) is an effective\ntreatment for MDD, also in TRD. Yet, the position of ECT as \u201ctreatment-of-lastresort\u201d may decrease the likelihood of beneficial outcome. Our aim was to investigate the association between treatment resistance and outcome and course of ECT.\nMethods: We performed a retrospective, multicenter cohort study with\n440 patients of which data was retrieved from patient records as collected in\nthe Dutch ECT Cohort database. Linear and logistic regression models were\nused to explore the association between level of treatment resistance and outcome of ECT. Median split was used to explore the differences between high\nand low level of TRD and course of treatment.\nResults: A higher DM-TRD score was associated with significantly smaller\nreduction of depression symptoms (R2 = 0.160; \u03b2 = \u00012.968; p < 0.001) and\nlower chance of response (OR = 0.821 [95 CI: 0.760\u20130.888]; \u03b2 = \u00010.197;\np < 0.001). Low level TRD patients underwent fewer ECT sessions (mean 13\n\u00b1 6 SD vs. 16 \u00b1 7 SD; p < 0.001) and fewer switches from right unilateral tot\nbifrontotemporal electrode placement (29% vs. 40%; p = 0.032).\nConclusion: Reserving ECT as \u201ctreatment-of-last-resort\u201d in the treatment\nalgorithm for MDD seems questionable, because in our study lower level of\ntreatment resistance predicted more beneficial ECT-outcome. Moreover, providing ECT in less treatment resistant patients showed fewer needed ECTsessions and less switches to BL electrode placement, which may decrease the\nrisk for cognitive side-effects.\"><br><br><\/a><\/p>\n<\/div><\/div>\n\n\n<style>.kadence-column496_d3a931-f0 > .kt-inside-inner-col,.kadence-column496_d3a931-f0 > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column496_d3a931-f0 > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column496_d3a931-f0{position:relative;}<\/style>\n<div class=\"wp-block-kadence-column kadence-column496_d3a931-f0\"><div class=\"kt-inside-inner-col\"><\/div><\/div>\n\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Pre-treatment predictors of cognitive side-effects after treatment with electroconvulsive therapy in patients with depression: A multicenter study D. Loef, P.F.P. van Eijndhoven, E.&hellip;<\/p>\n","protected":false},"author":1,"featured_media":563,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-496","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research"],"_links":{"self":[{"href":"https:\/\/dutchectconsortium.nl\/index.php\/wp-json\/wp\/v2\/posts\/496","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dutchectconsortium.nl\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/dutchectconsortium.nl\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/dutchectconsortium.nl\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dutchectconsortium.nl\/index.php\/wp-json\/wp\/v2\/comments?post=496"}],"version-history":[{"count":6,"href":"https:\/\/dutchectconsortium.nl\/index.php\/wp-json\/wp\/v2\/posts\/496\/revisions"}],"predecessor-version":[{"id":571,"href":"https:\/\/dutchectconsortium.nl\/index.php\/wp-json\/wp\/v2\/posts\/496\/revisions\/571"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/dutchectconsortium.nl\/index.php\/wp-json\/wp\/v2\/media\/563"}],"wp:attachment":[{"href":"https:\/\/dutchectconsortium.nl\/index.php\/wp-json\/wp\/v2\/media?parent=496"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/dutchectconsortium.nl\/index.php\/wp-json\/wp\/v2\/categories?post=496"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/dutchectconsortium.nl\/index.php\/wp-json\/wp\/v2\/tags?post=496"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}