Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Sep 26;11(10):1273.
doi: 10.3390/brainsci11101273.

The Neurobiological Basis of Cognitive Side Effects of Electroconvulsive Therapy: A Systematic Review

Adriana Bassa  1   2 , Teresa Sagués  1 , Daniel Porta-Casteràs  1   2 , Pilar Serra  1 , Erika Martínez-Amorós  1   2 , Diego J Palao  1   2   3 , Marta Cano  1   3   4 , Narcís Cardoner  1   2   3
Affiliations
Review

The Neurobiological Basis of Cognitive Side Effects of Electroconvulsive Therapy: A Systematic Review

Adriana Bassa et al. Brain Sci. .

Abstract

Decades of research have consistently demonstrated the efficacy of electroconvulsive therapy (ECT) for the treatment of major depressive disorder (MDD), but its clinical use remains somewhat restricted because of its cognitive side effects. The aim of this systematic review is to comprehensively summarize current evidence assessing potential biomarkers of ECT-related cognitive side effects. Based on our systematic search of human studies indexed in PubMed, Scopus, and Web of Knowledge, a total of 29 studies evaluating patients with MDD undergoing ECT were reviewed. Molecular biomarkers studies did not consistently identify concentration changes in plasma S-100 protein, neuron-specific enolase (NSE), or Aβ peptides significantly associated with cognitive performance after ECT. Importantly, these findings suggest that ECT-related cognitive side effects cannot be explained by mechanisms of neural cell damage. Notwithstanding, S-100b protein and Aβ40 peptide concentrations, as well as brain-derived neurotrophic factor (BDNF) polymorphisms, have been suggested as potential predictive biomarkers of cognitive dysfunction after ECT. In addition, recent advances in brain imaging have allowed us to identify ECT-induced volumetric and functional changes in several brain structures closely related to memory performance such as the hippocampus. We provide a preliminary framework to further evaluate neurobiological cognitive vulnerability profiles of patients with MDD treated with ECT.

Keywords: ECT; MDD; NSE; S-100; biomarkers; cognitive impairment; electroconvulsive therapy; hippocampus; memory; side effects.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA block diagram depicting study search and selection process. WOS, Web of Knowledge.
See this image and copyright information in PMC

References

    1. Lisanby S.H., McClintock S.M., Alexopoulos G., Bailine S.H., Bernhardt E., Briggs M.C., Cullum C.M., De Deng Z., Dooley M., Geduldig E.T., et al. Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Venlafaxine in Geriatric Depression: Phase 1 of the PRIDE Study. Am. J. Geriatr. Psychiatry. 2020;28:304–316. doi: 10.1016/j.jagp.2019.10.003. - DOI - PMC - PubMed
    1. McClintock S.M., Choi J., Deng Z.-D., Appelbaum L.G., Krystal A.D., Lisanby S.H. Multifactorial Determinants of the Neurocognitive Effects of Electroconvulsive Therapy. J. ECT. 2014;30:165–176. doi: 10.1097/YCT.0000000000000137. - DOI - PMC - PubMed
    1. Sobin C., Sackeim H.A., Prudic J., Devanand D.P., Moody B.J., McElhiney M.C. Predictors of retrograde amnesia following ECT. Am. J. Psychiatry. 1995;152:995–1001. doi: 10.1176/ajp.152.7.995. - DOI - PubMed
    1. Loo C.K., Schweitzer I., Pratt C. Recent advances in optimizing electroconvulsive therapy. Aust. N. Z. J. Psychiatry. 2006;40:632–638. doi: 10.1080/j.1440-1614.2006.01862.x. - DOI - PubMed
    1. Sackeim H.A. The impact of electroconvulsive therapy on brain grey matter volume: What does it mean? Brain Stimul. 2020;13:1226–1231. doi: 10.1016/j.brs.2020.04.014. - DOI - PubMed

LinkOut - more resources