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Electroconvulsive therapy for depression: seizure quality markers and cognition

Murilo Carvalho Lobato, Gabriel Magalhaes Nunes Guimaraes, Helga Bezerra Gomes da Silva, Joao Armando de Castro Santos, Raphael Boechat Barros.

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Objectives: Electroconvulsive Therapy (ECT) is the most effective therapy for patients with treatment-resistant depression. The stimulus parameters may be related to the outcome, and also to the cognitive changes reported in this treatment. Our objective was to list which factors could be considered as markers of quality of crisis and to verify cognition impairments.
Methods: This is a real world study (not interventionist).Eighteen patients with depressive episode and treatment-resistant were selected Tests applied before and 15 days after the last session:The Montreal Cognitive Assessment (MoCA), Verbal Fluency Test (TFV), The Quality of Life Satisfaction and Satisfaction Questionnaire (Q-LES-Q-SF). The mood was measured by Hamilton-D-17 (HAM-D-17) at five different times
Results: There was a consistent decrease in the HAM-D-17 score during the sessions. There was response in 55.55% and remission in 44.44% and an increase in the Q-LES-Q-SF score demonstrating the therapeutic value of ECT. There were no detectable cognitive changes two weeks after the end of the sessions. Statistical tests have proven that cardiac monitoring added to the monitoring of seizure duration are useful to monitor the quality of seizures.
Conclusion: ECT are effective for treating depression and do not cause cognition impairment 15 days after treatment. Simple methods such as heart rate monitoring and duration of central and motor crises are important as a criterion for monitoring the quality of seizures. The study should be replicated in larger samples to ensure that the generalizations of these conclusions are solid.

Key words: electroconvulsive therapy, depression, response predictor, cognition

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