Cognitive Training for Memory Deficits Associated With Electroconvulsive Therapy
Condition: Memory Deficits; Electroconvulsive Therapy
MeSH terms: Memory Disorders
Study type: Interventional

Summary: 
      Although electroconvulsive therapy (ECT) remains the most effective treatment for people with
      severe depression, patients may experience a significant degree of persistent and/or
      permanent memory problems following ECT. Many patients report the memory problems are the
      most disturbing and serious side effect of ECT, and that such effects impact their quality of
      life following treatment and their willingness to consent to further ECT needed to complete a
      treatment course or to maintain remission. New developments in the field of cognitive
      remediation have demonstrated the benefits of cognitive training to improve memory
      performance in various conditions, such as epilepsy. However, these strategies have never
      been applied to help patients regain memory after ECT. The investigators have designed and
      piloted a novel cognitive program specifically targeted to the cognitive effects of ECT,
      based upon a program tailored to people with seizure disorders, a group with memory problems
      very similar to people who undergo ECT. This Memory Training for ECT (Mem-ECT) is designed to
      help cognitive functions that may be compromised following ECT remain relatively preserved.
      In addition, the intervention attempts to help ECT patients quickly regain their general
      memory skills immediately following ECT. Recent results from our preliminary group of
      patients who underwent ECT and memory training at New York Presbyterian shows no overall
      decline in memory function following ECT. On the basis of these promising findings, the
      investigators propose a more rigorous and larger study to confirm whether this novel memory
      training program can help alleviate memory problems associated with ECT.
    

Detailed description: 
      The investigators propose to enroll 60 patients scheduled to undergo ECT over the course of 3
      years. They will be randomly assigned to one of three research conditions (a) participants in
      Mem-ECT condition will receive memory training before and after their ECT course, (b)
      participants in the active control condition will work on commercially available puzzle games
      at the same times prior and after ECT to determine if the developed memory training program
      is more effective than mere mental stimulation, (c) participants in the "treatment as usual"
      will not work on the memory training or the puzzle games but just undergo the study
      evaluations. Participants will be evaluated a few days before ECT, within 2 weeks following
      ECT, and once again 2 months later. The evaluation will consist of interviews, mental skill
      testing, and measuring brain waves using an electroencephalograph (EEG) before ECT and 2
      months after ECT (no EEG right after ECT). It is our hope that developing a safe and
      effective strategy to minimize the adverse memory side effects of ECT will make ECT a better
      and more easily tolerated treatment for patients with severe depression who need this
      therapeutic option.
    

Intervention name(s): Cognitive Intervention: Memory Training; Comparable general mental stimulation
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Paper-and-pencil and computerized exercises pre- and post-ECT which may be helpful in recovering episodic memories and allow for the retention of learned strategies; Active control will work on commercially available puzzle games at the same time prior and after ECT to determine if the developed memory training program is more effective than mere mental stimulation.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: ECT; Memory Training; Cognitive Remediation; Electroconvulsive Therapy; Treatment Resistant Depression; Depression; Geriatric Depression; Memory Loss; Cognitive Training