A long-term longitudinal follow-up of depressed patients treated with ECT with special focus on development of dementia. 2016

Åke Berggren, and Lars Gustafson, and Peter Höglund, and Aki Johanson
Department of Psychology, Lund University, Lund, Sweden; Department of Anaesthesia, Blekinge Hospital, Karlskrona, Sweden; Department of Psychiatry, Clinical Sciences, Lund University, Lund, Sweden. Electronic address: ake.berggren@ltblekinge.se.

In this study, the long term effects of ECT on patients with depression were investigated through repeated rCBF and EEG measures as well as clinical characteristics over several years. The aim of the investigation was to establish an association with the eventual development of dementia. A cohort of forty-nine patients (21 men and 28 women) with a mean age of 61 years underwent ECT. A subsequent evaluation from medical records and three rating-scales for diagnosis of Alzheimer´s disease (AD), fronto-temporal dementia (FTD), and for vascular dementia (VaD), revealed that 17 patients (8 men and 9 women), had developed dementia. These cases were compared to the 32 patients (13 men and 19 women), who had not developed dementia. Initially, the dementia group, compared to those without dementia, showed a lower hemispheric CBF (left side; p=.029, right side; p=.033), and a lower mean occipital EEG frequency (p=.048). After the first ECT-series, an increase in general disorientation (p=.015), personal disorientation (p=.009), and subsequently, spatial disorientation (p=.021), were seen in the dementia group. There were no differences in the clinical response or remissions after treatment in the groups. The small sample-size, which did not allow for the comparison of characteristics between different dementias. Depressed older patients who later developed dementia showed lower hemispheric mean level of CBF and EEG mean frequency before ECT and higher personal and spatial disorientation following ECT.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009483 Neuropsychological Tests Tests designed to assess neurological function associated with certain behaviors. They are used in diagnosing brain dysfunction or damage and central nervous system disorders or injury. Aphasia Tests,Cognitive Test,Cognitive Testing,Cognitive Tests,Memory for Designs Test,Neuropsychological Testing,AX-CPT,Behavioral Assessment of Dysexecutive Syndrome,CANTAB,Cambridge Neuropsychological Test Automated Battery,Clock Test,Cognitive Function Scanner,Continuous Performance Task,Controlled Oral Word Association Test,Delis-Kaplan Executive Function System,Developmental Neuropsychological Assessment,Hooper Visual Organization Test,NEPSY,Neuropsychologic Tests,Neuropsychological Test,Paced Auditory Serial Addition Test,Repeatable Battery for the Assessment of Neuropsychological Status,Rey-Osterrieth Complex Figure,Symbol Digit Modalities Test,Test of Everyday Attention,Test, Neuropsychological,Tests, Neuropsychological,Tower of London Test,Neuropsychologic Test,Test, Cognitive,Testing, Cognitive,Testing, Neuropsychological,Tests, Cognitive
D009778 Occipital Lobe Posterior portion of the CEREBRAL HEMISPHERES responsible for processing visual sensory information. It is located posterior to the parieto-occipital sulcus and extends to the preoccipital notch. Annectant Gyrus,Calcarine Fissure,Calcarine Sulcus,Cuneate Lobule,Cuneus,Cuneus Cortex,Cuneus Gyrus,Gyrus Lingualis,Lingual Gyrus,Lunate Sulcus,Medial Occipitotemporal Gyrus,Occipital Cortex,Occipital Gyrus,Occipital Region,Occipital Sulcus,Sulcus Calcarinus,Calcarine Fissures,Calcarinus, Sulcus,Cortex, Cuneus,Cortex, Occipital,Cortices, Cuneus,Cortices, Occipital,Cuneate Lobules,Cuneus Cortices,Fissure, Calcarine,Fissures, Calcarine,Gyrus Linguali,Gyrus, Annectant,Gyrus, Cuneus,Gyrus, Lingual,Gyrus, Medial Occipitotemporal,Gyrus, Occipital,Linguali, Gyrus,Lingualis, Gyrus,Lobe, Occipital,Lobes, Occipital,Lobule, Cuneate,Lobules, Cuneate,Occipital Cortices,Occipital Lobes,Occipital Regions,Occipitotemporal Gyrus, Medial,Region, Occipital,Regions, Occipital,Sulcus, Calcarine,Sulcus, Lunate,Sulcus, Occipital
D012039 Regional Blood Flow The flow of BLOOD through or around an organ or region of the body. Blood Flow, Regional,Blood Flows, Regional,Flow, Regional Blood,Flows, Regional Blood,Regional Blood Flows
D002540 Cerebral Cortex The thin layer of GRAY MATTER on the surface of the CEREBRAL HEMISPHERES that develops from the TELENCEPHALON and folds into gyri and sulci. It reaches its highest development in humans and is responsible for intellectual faculties and higher mental functions. Allocortex,Archipallium,Cortex Cerebri,Cortical Plate,Paleocortex,Periallocortex,Allocortices,Archipalliums,Cerebral Cortices,Cortex Cerebrus,Cortex, Cerebral,Cortical Plates,Paleocortices,Periallocortices,Plate, Cortical
D003704 Dementia An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. Senile Paranoid Dementia,Amentia,Familial Dementia,Amentias,Dementia, Familial,Dementias,Dementias, Familial,Dementias, Senile Paranoid,Familial Dementias,Paranoid Dementia, Senile,Paranoid Dementias, Senile,Senile Paranoid Dementias
D003865 Depressive Disorder, Major Disorder in which five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Symptoms include: depressed mood most of the day, nearly every daily; markedly diminished interest or pleasure in activities most of the day, nearly every day; significant weight loss when not dieting or weight gain; Insomnia or hypersomnia nearly every day; psychomotor agitation or retardation nearly every day; fatigue or loss of energy nearly every day; feelings of worthlessness or excessive or inappropriate guilt; diminished ability to think or concentrate, or indecisiveness, nearly every day; or recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt. (DSM-5) Depression, Involutional,Major Depressive Disorder,Melancholia, Involutional,Paraphrenia, Involutional,Psychosis, Involutional,Depressive Disorders, Major,Involutional Depression,Involutional Melancholia,Involutional Paraphrenia,Involutional Paraphrenias,Involutional Psychoses,Involutional Psychosis,Major Depressive Disorders,Paraphrenias, Involutional,Psychoses, Involutional
D004292 Dominance, Cerebral Dominance of one cerebral hemisphere over the other in cerebral functions. Cerebral Dominance,Hemispheric Specialization,Dominances, Cerebral,Specialization, Hemispheric
D004565 Electroconvulsive Therapy Electrically induced CONVULSIONS primarily used in the treatment of severe AFFECTIVE DISORDERS and SCHIZOPHRENIA. Convulsive Therapy, Electric,ECT (Psychotherapy),Electroshock Therapy,Shock Therapy, Electric,Convulsive Therapies, Electric,Electric Convulsive Therapies,Electric Convulsive Therapy,Electric Shock Therapies,Electric Shock Therapy,Electroconvulsive Therapies,Electroshock Therapies,Shock Therapies, Electric,Therapies, Electric Convulsive,Therapies, Electric Shock,Therapies, Electroconvulsive,Therapies, Electroshock,Therapy, Electric Convulsive,Therapy, Electric Shock,Therapy, Electroconvulsive,Therapy, Electroshock

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