Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-18T21:09:36.142Z Has data issue: false hasContentIssue false
  • English
  • Français

Using the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess the cognitive impact of electroconvulsive therapy on visual and visuospatial memory

Published online by Cambridge University Press:  24 September 2009

D. W. Falconer ,
J. Cleland ,
S. Fielding  and
I. C. Reid
D. W. Falconer
Affiliation:
Department of Mental Health, Clinical Research Centre, Royal Cornhill Hospital, University of Aberdeen, UK
J. Cleland
Affiliation:
Department of General Practice and Primary Care, School of Medicine, University of Aberdeen, UK
S. Fielding
Affiliation:
Department of Public Health, University of Aberdeen, UK
I. C. Reid*
Affiliation:
Department of Mental Health, Clinical Research Centre, Royal Cornhill Hospital, University of Aberdeen, UK
*
*Address for correspondence: I. C. Reid, Department of Mental Health, Clinical Research Centre, Royal Cornhill Hospital, University of Aberdeen, Aberdeen AB25 2ZH, UK. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The cognitive impact of electroconvulsive therapy (ECT) is rarely measured systematically in everyday clinical practice even though patient and clinician acceptance is limited by its adverse affect on memory. If patients are tested it is often with simple paper and pencil tests of visual or verbal memory. There are no reported studies of computerized neuropsychological testing to assess the cognitive impact of ECT on visuospatial memory.

Method

Twenty-four patients with severe depression were treated with a course of bilateral ECT and assessed with a battery of visual memory tests within the Cambridge Neuropsychological Test Automated Battery (CANTAB). These included spatial and pattern recognition memory, pattern-location associative learning and a delayed matching to sample test. Testing was carried out before ECT, during ECT, within the week after ECT and 1 month after ECT.

Results

Patients showed significant impairments in visual and visuospatial memory both during and within the week after ECT. Most impairments resolved 1 month following ECT; however, significant impairment in spatial recognition memory remained. This is one of only a few studies that have detected anterograde memory deficits more than 2 weeks after treatment.

Conclusions

Patients receiving ECT displayed a range of visual and visuospatial deficits over the course of their treatment. These deficits were most prominent for tasks dependent on the use of the right medial temporal lobe; frontal lobe function may also be implicated. The CANTAB appears to be a useful instrument for measuring the adverse cognitive effects of ECT on aspects of visual and visuospatial memory.

Keywords

CANTABelectroconvulsive therapyvisual memory
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 6 , June 2010 , pp. 1017 - 1025
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barr, WB (1997). Examining the right temporal lobe's role in nonverbal memory. Brain and Cognition 35, 26–41.CrossRefGoogle ScholarPubMed
Eichenbaum, H (1999). The hippocampus and mechanisms of declarative memory. Behavioural Brain Research 103, 123–133.CrossRefGoogle ScholarPubMed
Elliott, R, McKenna, PJ, Robbins, TW, Sahakian, BJ (1996). Neuropsychological impairments in unipolar depression: the role of perceived failure on subsequent performance. Psychological Medicine 26, 975–989.CrossRefGoogle Scholar
Folstein, MF, Folstein, SE, McHugh, PR (1975). Mini-Mental State: a practical method for grading the cognitive status of patients for the clinician. Journal of Psychiatric Research 12, 189–198.CrossRefGoogle Scholar
Fowler, KS, Saling, MM, Conway, EL, Semple, JM, Louis, WJ (1997). Computerised neuropsychological tests in the early detection of dementia: prospective findings. Journal of the International Neuropsychological Society 3, 139–146.CrossRefGoogle ScholarPubMed
Fraser, RM, Glass, IB (1980). Unilateral and bilateral ECT in elderly patients. A comparative study. Acta Psychiatrica Scandinavica 62, 13–31.CrossRefGoogle ScholarPubMed
Fray, PJ, Robbins, TW, Sahakian, BJ (1996). Neuropsychological applications of CANTAB. International Journal of Geriatric Psychiatry 11, 329–336.3.0.CO;2-6>CrossRefGoogle Scholar
Goldstein, SG, Filskov, SB, Weaver, LA (1977). Neuropsychological effects of electroconvulsive therapy. Journal of Clinical Psychiatry 33, 798–806.Google ScholarPubMed
Gueorguieva, R, Krystal, JH (2004). Move over ANOVA: progress in analysing repeated-measure data and its reflection in papers published in the Archives of General Psychiatry. Archives of General Psychiatry 61, 310–317.CrossRefGoogle Scholar
Halliday, AM, Davidson, K, Browne, MW, Kreeger, LC (1968). A comparison of the effects on depression and memory of bilateral ECT and unilateral ECT to the dominant and non-dominant hemispheres. British Journal of Psychiatry 114, 997–1012.CrossRefGoogle Scholar
Howell, DC (1997). Statistical Methods in Psychology. Duberry Press: Belmont, CA.Google Scholar
Lange, KW, Sahakian, BJ, Quinn, NP, Marsden, CD, Robbins, TW (1995). Comparison of executive and visuospatial memory function in Huntington's disease and dementia of Alzheimer's type matched for degree of dementia. Journal of Neurology, Neurosurgery and Psychiatry 58, 598–606.CrossRefGoogle ScholarPubMed
Lawrence, AD, Watkins, LHA, Sahakian, BJ, Hodges, JR, Robbins, TW (2000). Visual object and visuospatial cognition in Huntington's disease: implications for information processing in corticostriatal circuits. Brain 123, 1349–1364.CrossRefGoogle ScholarPubMed
Lee, ACH, Rahman, S, Hodges, JR, Sahakian, B, Graham, KS (2003). Associate and recognition memory for novel objects in dementia: implications for diagnosis. European Journal of Neuroscience 18, 1660–1670.CrossRefGoogle ScholarPubMed
Lerer, B, Shapira, B, Calev, A, Tubi, N, Drexler, H, Kindler, S, Lidsky, D, Schwartz, JE (1995). Antidepressant and cognitive effects of twice vs three times weekly ECT. American Journal of Psychiatry 152, 564–570.Google Scholar
Luciana, M (2003). Practitioner review: computerized assessment of neuropsychological function in children: clinical and research applications of Cambridge Neuropsychological Testing Automated Battery (CANTAB). Journal of Child Psychology and Psychiatry 5, 649–663.CrossRefGoogle Scholar
Maguire, EA, Frackowiak, RS, Frith, CD (1996). Learning to find your way: a role for the human hippocampal formation. Proceedings of the Royal Society of London 263, 1745–1750.Google Scholar
Manns, JR, Squire, LR (1999). Impaired recognition memory on the Doors & People Test after damage limited to the hippocampus region. Hippocampus 9, 495–499.3.0.CO;2-O>CrossRefGoogle Scholar
McCall, WV, Dunn, A, Rosenquist, PB (2004). Quality of life and function after ECT. British Journal of Psychiatry 185, 405–409.CrossRefGoogle Scholar
Milner, B (1965). Visually-guided maze learning in man: effects of bilateral hippocampal, bilateral frontal, and unilateral cerebral lesions. Neuropsychologia 3, 317–338.CrossRefGoogle Scholar
Milner, B (1975). Psychological aspects of focal epilepsy and its neurosurgical management. Advances in Neurology 8, 229–321.Google ScholarPubMed
Montgomery, SA, Åsberg, M (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry 134, 382–389.CrossRefGoogle ScholarPubMed
Morris, RGM (1989). Synaptic plasticity and learning: selective impairment of learning in rats and blockade of long-term potentiation in vivo by N-methyl-d aspartate receptor antagonist AP5. Journal of Neuroscience 9, 3040–3057.CrossRefGoogle ScholarPubMed
Ng, C, Schweitzer, I, Alexopoulos, P, Celi, E, Wong, L, Tuckwell, V, Sergejew, A, Tiller, J (2000). Efficacy and cognitive effects of right unilateral electroconvulsive therapy. Journal of ECT 16, 370–379.CrossRefGoogle ScholarPubMed
Owen, AM, Iddon, JL, Hodges, JR, Summers, BA, Robbins, TW (1997). Spatial and non-spatial working memory at different stages of Parkinson's disease. Neuropsychologia 35, 519–532.CrossRefGoogle ScholarPubMed
Owen, AM, Morris, RG, Sahakian, BJ, Polkey, CE, Robbins, TW (1996). Double dissociations of memory and executive functions in working memory task following frontal lobe excisions, temporal lobe excisions, or amygdalo-hippocampectomy in man. Brain 119, 1597–1615.CrossRefGoogle ScholarPubMed
Owen, AM, Sahakian, BJ, Semple, J, Polkey, CE, Robbins, TW (1995). Visuo-spatial short-term recognition memory and learning after temporal lobe excision, frontal lobe excision or amygdalo-hyppocampectomy in man. Neuropsychologia 33, 1–24.CrossRefGoogle ScholarPubMed
Porter, RJ, Gallagher, P, Thompson, JM, Young, AH (2003). Neurocognitive impairment in drug-free patients with major depressive disorder. British Journal of Psychiatry 182, 214–220.CrossRefGoogle ScholarPubMed
Rahman, S, Robbins, TW, Sahakian, BJ (1999). Comparative cognitive neuropsychological studies of frontal lobe function: implications for therapeutic strategies in frontal variant frontotemporal dementia. Dementia and Geriatric Cognitive Disorders 10, 15–28.CrossRefGoogle ScholarPubMed
Rami-Gonzajez, L, Bernardo, M, Boget, T, Gil-Verona, JA, Salamero, M, Junque, C (2001). Subtypes of memory dysfunction associated with ECT: characteristics and neurobiological bases. Journal of ECT 17, 129–135.CrossRefGoogle Scholar
Reid, IC, Stewart, CA (1997). Seizures, memory and synaptic plasticity. Seizure 6, 351–359.CrossRefGoogle ScholarPubMed
Robbins, TW, James, M, Owen, AM, Sahakian, BJ, McInnes, L, Rabbitt, P (1994). Cambridge Neuropsychological Test Automated Battery (CANTAB): a factor analytic study in a large number of normal elderly volunteers. Dementia 5, 266–281.Google Scholar
Robertson, H, Pryor, H (2006). Memory and cognitive effects of ECT: informing and assessing patients. Advances in Psychiatric Treatment 12, 228–238.CrossRefGoogle Scholar
Ryan, JJ, Geisser, ME, Randall, DM, Georgemiller, RJ (1986). Alternate form reliability and equivalency of the Rey Auditory Verbal Learning Test. Journal of Clinical and Experimental Neuropsychology 8, 611–616.CrossRefGoogle ScholarPubMed
Sackeim, HA (1992). The Cognitive Effects of Electroconvulsive Therapy in Cognitive Disorders: Pathophysiology and Treatment. Marcel Dekker: New York.Google Scholar
Sackeim, HA, Prudic, J, Devanand, DP, Kiersky, JE, Fitzsimons, L, Moody, BJ, McElhiney, MC, Coleman, EA, Settembrino, JM (1993). Effects of stimulus intensity and electrode placement on the efficacy and cognitive effects of electroconvulsive therapy. New England Journal of Medicine 328, 839–846.CrossRefGoogle ScholarPubMed
Sackeim, HA, Prudic, J, Devanand, DP, Nobler, MS, Lisanby, SH, Peyser, S, Fitzsimons, L, Moody, BJ, Clark, J (2000). A prospective, randomised, double-blind comparison of bilateral and right unilateral electroconvulsive therapy at different stimulus intensities. Archives of General Psychiatry 57, 425–433.CrossRefGoogle ScholarPubMed
Sackeim, HA, Prudic, J, Fuller, R, Keilp, J, Lavori, PW, Olfson, M (2007). The cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacology 32, 244–254.CrossRefGoogle ScholarPubMed
Sahakian, BJ, Morris, RG, Evenden, JL, Heald, A, Levy, R, Philpot, M, Robbins, TW (1988). A comparative study of visuospatial memory and learning in Alzheimer-type dementia and Parkinson's disease. Brain 111, 695–718.CrossRefGoogle ScholarPubMed
Sahakian, BJ, Downes, JJ, Eagger, S, Evenden, JL, Levy, R, Philpot, MP, Roberts, AC, Robbins, TW (1990). Sparing of attentional relative to mnemonic function in a subgroup of patients with dementia of the Alzheimer's type. Neuropsychologia 28, 1197–1213.CrossRefGoogle Scholar
Sahgal, A, Sahakian, BJ, Robbins, TW, Wray, CJ, Lloyd, S, Cook, JH, McKeith, IG, Disley, JCA, Eagger, S, Boddington, S, Edwardson, JA (1991). Detection of visual memory and learning deficits in Alzheimer's disease using the Cambridge Neuropsychological Test Automated Battery. Dementia 2, 150–158.Google Scholar
Scott, AIF (editor) (2005). The ECT Handbook, 2nd edn. The Third Report of the Royal College of Psychiatrists' Special Committee on ECT. Council Report CR128. Bell and Bain Limited: Glasgow.Google Scholar
Smith, M, Milner, B (1981). The role of the hippocampus in the recall of spatial locations. Neuropsychologia 19, 781–793.CrossRefGoogle Scholar
Spreen, O, Strauss, E (1991). A Compendium of Neuropsychological Tests. Oxford University: New York.Google Scholar
Squire, LR (1986). Memory functions as affected by ECT. Annals of the New York Academy of Sciences 462, 307–314.CrossRefGoogle Scholar
Squire, LR, Miller, PL (1974). Diminution of anterograde amnesia following electroconvulsive therapy. British Journal of Psychiatry 125, 490–495.CrossRefGoogle ScholarPubMed
Squire, LR, Slater, PC (1978). Bilateral and unilateral ECT: effects on verbal and nonverbal memory. American Journal of Psychiatry 135, 1316–1320.Google ScholarPubMed
UK ECT Review Group (2003). Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 361, 799–808.CrossRefGoogle Scholar
Wechsler, D (1987). Manual for the Wechsler Memory Scale – Revised. The Psychological Corporation: San Antonio, TX.Google Scholar