Electroconvulsive therapy and cognitive performance from the Global ECT MRI Research Collaboration

Maximilian Kiebs¹, Danielle C Farrar², Antoine Yrondi³, Narcis Cardoner⁴, Noora Tuovinen⁵, Ronny Redlich⁶, Udo Dannlowski⁷, Carles Soriano-Mas⁸, Annemiek Dols⁹, Akihiro Takamiya¹⁰, Indira Tendolkar¹¹, Katherine L Narr¹², Randall Espinoza¹², Maarten Laroy¹³, Philip van Eijndhoven¹¹, Esmée Verwijk¹⁴, Jeroen van Waarde¹⁵, Joey Verdijk¹⁵, Hannah B Maier¹⁶, Pia Nordanskog¹⁷, Guido van Wingen¹⁸, Linda van Diermen¹⁹, Louise Emsell²⁰, Filip Bouckaert²⁰, Jonathan Repple²¹, Joan A Camprodon²², Benjamin S C Wade²², K Tristan Donaldson²², Leif Oltedal²³, Ute Kessler²⁴, Åsa Hammar²⁵, Pascal Sienaert²⁶, Kaat Hebbrecht²⁶, Mikel Urretavizcaya²⁷, Jean-Baptiste Belge²⁸, Miklos Argyelan²⁹, Mate Baradits³⁰, Jasmien Obbels²⁶, Bogdan Draganski³¹, Alexandra Philipsen³², Alexander Sartorius³³, Didericke Rhebergen³⁴, Olga Therese Ousdal³⁵, René Hurlemann³⁶, Shawn McClintock³⁷, Erik B Erhardt³⁸, Christopher C Abbott³⁹

Affiliations

¹ Department of Psychiatry and Psychotherapy, School of Medicine and Health Sciences, University of Oldenburg, Oldenberg, Germany; Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany. Electronic address: m.kiebs@uol.de.
² Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM, USA.
³ Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante FondaMental, CHU de Toulouse, Hôpital Purpan, ToNIC Toulouse NeuroImaging Centre, Toulouse, France; Université de Toulouse, INSERM, UPS, Toulouse, France.
⁴ Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; Network Center for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
⁵ Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University of Innsbruck, Innsbruck, Austria.
⁶ Department of Psychology, University of Halle, Germany; Institute of Translational Psychiatry, University of Muenster, Germany; Halle-Jena-Magdeburg, German Center for Mental Health (DZPG), Germany.
⁷ Institute of Translational Psychiatry, University of Muenster, Germany.
⁸ Network Center for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Social Psychology and Quantitative Psychology, Institute of Neurosciences, Universitat de Barcelona - UB, Barcelona, Spain.
⁹ Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Psychiatry, Amsterdam UMC location, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
¹⁰ Department of Neurosciences, Neuropsychiatry, Leuven Brain Institute, KU Leuven, Leuven, Belgium; Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan.
¹¹ Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
¹² Departments of Neurology and Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
¹³ Department of Neurosciences, Neuropsychiatry, Leuven Brain Institute, KU Leuven, Leuven, Belgium.
¹⁴ Department of Psychology, Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands; Department of Medical Psychology, UMC Amsterdam, Amsterdam, the Netherlands; ECT-Department, Parnassia Psychiatric Institute, The Hague, the Netherlands.
¹⁵ Department of Psychiatry, Rijnstate, Arnhem, the Netherlands.
¹⁶ Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany.
¹⁷ Center for Social and Affective Neuroscience (CSAN), Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Psychiatry in Linköping, Linköping, Sweden.
¹⁸ Department of Psychiatry, Amsterdam UMC location, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Neuroscience Amsterdam, the Netherlands.
¹⁹ Department of Psychiatry, University Hospital of Liège, Liege, Belgium; Department of Psychiatry, Radboud University Medical Centre, Nijmegen, the Netherlands.
²⁰ Department of Neurosciences, Neuropsychiatry, Leuven Brain Institute, KU Leuven, Leuven, Belgium; Geriatric Psychiatry, University Psychiatry Center (UPC), KU Leuven, Leuven, Belgium.
²¹ Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany; Institute for Translational Psychiatry, University of Münster, Münster, Germany.
²² Division of Neuropsychiatry and Neuromodulation, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
²³ Department of Clinical Medicine, University of Bergen, Bergen, Norway; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway.
²⁴ Department of Psychiatry, Haukeland University Hospital, Bergen, Norway; University of Bergen, Bergen, Norway.
²⁵ Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway; Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Skåne, Sweden.
²⁶ Academic Center for ECT and Neuromodulation (AcCENT), Department of Neurosciences, Neuropsychiatry, University Psychiatry Center (UPC), KU Leuven, Leuven, Belgium.
²⁷ Network Center for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Neurosciences Group - Psychiatry and Mental Health, Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.
²⁸ Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
²⁹ Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY, USA.
³⁰ Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY, USA.
³¹ Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Neurology Department, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
³² Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
³³ Department of Psychiatry and Psychotherapy, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
³⁴ Department of Psychiatry, Amsterdam UMC location, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; GGZ Central, Mental Health Institute, Amersfoort, the Netherlands.
³⁵ Department of Biomedicine, Faculty of Medicine, University of Bergen, Norway.
³⁶ Department of Psychiatry and Psychotherapy, School of Medicine and Health Sciences, University of Oldenburg, Oldenberg, Germany.
³⁷ Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA.
³⁸ Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM, USA.
³⁹ Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM, USA. Electronic address: CAbbott@salud.unm.edu.

PMID: 39312853
PMCID: PMC11869118 (available on 2025-11-01)
DOI: 10.1016/j.jpsychires.2024.09.013

Electroconvulsive therapy and cognitive performance from the Global ECT MRI Research Collaboration

Maximilian Kiebs et al. J Psychiatr Res. 2024 Nov.

. 2024 Nov:179:199-208.

doi: 10.1016/j.jpsychires.2024.09.013. Epub 2024 Sep 18.

Authors

Affiliations

¹ Department of Psychiatry and Psychotherapy, School of Medicine and Health Sciences, University of Oldenburg, Oldenberg, Germany; Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany. Electronic address: m.kiebs@uol.de.
² Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM, USA.
³ Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante FondaMental, CHU de Toulouse, Hôpital Purpan, ToNIC Toulouse NeuroImaging Centre, Toulouse, France; Université de Toulouse, INSERM, UPS, Toulouse, France.
⁴ Sant Pau Mental Health Research Group, Institut d'Investigació Biomèdica Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; Network Center for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
⁵ Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University of Innsbruck, Innsbruck, Austria.
⁶ Department of Psychology, University of Halle, Germany; Institute of Translational Psychiatry, University of Muenster, Germany; Halle-Jena-Magdeburg, German Center for Mental Health (DZPG), Germany.
⁷ Institute of Translational Psychiatry, University of Muenster, Germany.
⁸ Network Center for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Social Psychology and Quantitative Psychology, Institute of Neurosciences, Universitat de Barcelona - UB, Barcelona, Spain.
⁹ Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Psychiatry, Amsterdam UMC location, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
¹⁰ Department of Neurosciences, Neuropsychiatry, Leuven Brain Institute, KU Leuven, Leuven, Belgium; Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan.
¹¹ Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.
¹² Departments of Neurology and Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
¹³ Department of Neurosciences, Neuropsychiatry, Leuven Brain Institute, KU Leuven, Leuven, Belgium.
¹⁴ Department of Psychology, Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands; Department of Medical Psychology, UMC Amsterdam, Amsterdam, the Netherlands; ECT-Department, Parnassia Psychiatric Institute, The Hague, the Netherlands.
¹⁵ Department of Psychiatry, Rijnstate, Arnhem, the Netherlands.
¹⁶ Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany.
¹⁷ Center for Social and Affective Neuroscience (CSAN), Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Psychiatry in Linköping, Linköping, Sweden.
¹⁸ Department of Psychiatry, Amsterdam UMC location, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Neuroscience Amsterdam, the Netherlands.
¹⁹ Department of Psychiatry, University Hospital of Liège, Liege, Belgium; Department of Psychiatry, Radboud University Medical Centre, Nijmegen, the Netherlands.
²⁰ Department of Neurosciences, Neuropsychiatry, Leuven Brain Institute, KU Leuven, Leuven, Belgium; Geriatric Psychiatry, University Psychiatry Center (UPC), KU Leuven, Leuven, Belgium.
²¹ Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany; Institute for Translational Psychiatry, University of Münster, Münster, Germany.
²² Division of Neuropsychiatry and Neuromodulation, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
²³ Department of Clinical Medicine, University of Bergen, Bergen, Norway; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway.
²⁴ Department of Psychiatry, Haukeland University Hospital, Bergen, Norway; University of Bergen, Bergen, Norway.
²⁵ Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway; Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Skåne, Sweden.
²⁶ Academic Center for ECT and Neuromodulation (AcCENT), Department of Neurosciences, Neuropsychiatry, University Psychiatry Center (UPC), KU Leuven, Leuven, Belgium.
²⁷ Network Center for Biomedical Research on Mental Health (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Neurosciences Group - Psychiatry and Mental Health, Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.
²⁸ Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
²⁹ Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY, USA.
³⁰ Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY, USA.
³¹ Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Neurology Department, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
³² Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
³³ Department of Psychiatry and Psychotherapy, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
³⁴ Department of Psychiatry, Amsterdam UMC location, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; GGZ Central, Mental Health Institute, Amersfoort, the Netherlands.
³⁵ Department of Biomedicine, Faculty of Medicine, University of Bergen, Norway.
³⁶ Department of Psychiatry and Psychotherapy, School of Medicine and Health Sciences, University of Oldenburg, Oldenberg, Germany.
³⁷ Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA.
³⁸ Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM, USA.
³⁹ Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM, USA. Electronic address: CAbbott@salud.unm.edu.

PMID: 39312853
PMCID: PMC11869118 (available on 2025-11-01)
DOI: 10.1016/j.jpsychires.2024.09.013

Abstract

The Global ECT MRI Research Collaboration (GEMRIC) has collected clinical and neuroimaging data of patients treated with electroconvulsive therapy (ECT) from around the world. Results to date have focused on neuroimaging correlates of antidepressant response. GEMRIC sites have also collected longitudinal cognitive data. Here, we summarize the existing GEMRIC cognitive data and provide recommendations for prospective data collection for future ECT-imaging investigations. We describe the criteria for selection of cognitive measures for mega-analyses: Trail Making Test Parts A (TMT-A) and B (TMT-B), verbal fluency category (VFC), verbal fluency letter (VFL), and percent retention from verbal learning and memory tests. We performed longitudinal data analysis focused on the pre-/post-ECT assessments with healthy comparison (HC) subjects at similar timepoints and assessed associations between demographic and ECT parameters with cognitive changes. The study found an interaction between electrode placement and treatment number for VFC (F(1,107) = 4.14, p = 0.04). Higher treatment was associated with decreased VFC performance with right unilateral electrode placement. Percent retention showed a main effect for group, with post-hoc analysis indicating decreased cognitive performance among the HC group. However, there were no significant effects of group or group interactions observed for TMT-A, TMT-B, or VFL. We assessed the current GEMRIC cognitive data and acknowledge the limitations associated with this data set including the limited number of neuropsychological domains assessed. Aside from the VFC and treatment number relationship, we did not observe ECT-mediated neurocognitive effects in this investigation. We provide prospective cognitive recommendations for future ECT-imaging investigations focused on strong psychometrics and minimal burden to subjects.

Keywords: Cognition; Depression; Electroconvulsive therapy; Neuropsychology.

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Conflict of interest statement

Declaration of competing interest HBM part in educational events sponsored by Livanova and Rovi. RH has received consulting and speaker fees from Boehringer Ingelheim International GmbH, Janssen-Cilag GmbH and ROVI GmbH in the last three years. All other authors report no biomedical financial interests or potential conflicts of interest with this work.

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Electroconvulsive therapy and cognitive performance from the Global ECT MRI Research Collaboration

Affiliations

Electroconvulsive therapy and cognitive performance from the Global ECT MRI Research Collaboration

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical