Multifactorial determinants of the neurocognitive effects of electroconvulsive therapy.
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For many patients with neuropsychiatric illnesses, standard psychiatric treatments with mono or combination pharmacotherapy, psychotherapy, and transcranial magnetic stimulation are ineffective. For these patients with treatment-resistant neuropsychiatric illnesses, a main therapeutic option is electroconvulsive therapy (ECT). Decades of research have found ECT to be highly effective; however, it can also result in adverse neurocognitive effects. Specifically, ECT results in disorientation after each session, anterograde amnesia for recently learned information, and retrograde amnesia for previously learned information. Unfortunately, the neurocognitive effects and underlying mechanisms of action of ECT remain poorly understood. The purpose of this paper was to synthesize the multiple moderating and mediating factors that are thought to underlie the neurocognitive effects of ECT into a coherent model. Such factors include demographic and neuropsychological characteristics, neuropsychiatric symptoms, ECT technical parameters, and ECT-associated neurophysiological changes. Future research is warranted to evaluate and test this model, so that these findings may support the development of more refined clinical seizure therapy delivery approaches and efficacious cognitive remediation strategies to improve the use of this important and widely used intervention tool for neuropsychiatric diseases.
Published Version (Please cite this version)10.1097/YCT.0000000000000137
Publication InfoAppelbaum, Lawrence Gregory; Choi, J; Deng, ZD; Krystal, Andrew Darrell; Lisanby, Sarah Hollingsworth; & McClintock, SM (2014). Multifactorial determinants of the neurocognitive effects of electroconvulsive therapy. J ECT, 30(2). pp. 165-176. 10.1097/YCT.0000000000000137. Retrieved from https://hdl.handle.net/10161/10644.
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Associate Professor in Psychiatry and Behavioral Sciences
Greg Appelbaum is an Associate Professor in the Department of Psychiatry and Behavioral Sciences in the Duke University School of Medicine. He is a member of the Brain Stimulation Division of Psychiatry, where he directs the Human Performance Optimization lab (Opti Lab) and the Brain Stimulation Research Center As a member
Professor Emeritus of Psychiatry and Behavioral Sciences
My research is focused on better understanding the pathophysiology of sleep disorders and mood disorders and developing improved treatments for these conditions. My primary research tools are: electroencepahlography (EEG), polysomnography (PSG), computer signal analysis and modeling, functional magnetic resonance imaging (fMRI), and positron emission tomograophy (PET). Nearly all of my projects have been carried out with humans, however, projects are ongoing with gene knock-out models in
Adjunct Professor in the Department of Psychiatry and Behavioral Sciences
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