RCT for Electroconvulsive Treatment Followed by Cognitive Control Training
Condition: Depressive Episode; Electroconvulsive Therapy; Cognitive Remediation
Study type: Interventional

Summary: 
      Major depressive disorder (MDD) is worldwide one of the most prevalent and disabling mental
      health conditions. Electroconvulsive therapy (ECT) is a safe and effective treatment even
      though 6-month relapse rates are high. Cognitive side effects of ECT, such as reduced
      cognitive control, might trigger mechanisms that increase relapse in patients. As such,
      cognitive control training (CCT) holds promise as a non-pharmacological strategy to improve
      long-term effects of ECT (i.e., increase remission, and reduce depression relapse).
    

Detailed description: 
      Eighty-eight participants aged between 18-70 years with major depressive disorder who start
      electroconvulsive treatment (ECT) will be included in this randomized controlled trial (RCT).
      Following (partial) response to ECT treatment (at least a 25% reduction of clinical
      symptoms), participants will be randomly assigned to a computer based CCT or active placebo
      control. A first aim of this RCT is to assess the effects of CCT compared to an active
      placebo condition on depression symptomatology, cognitive complaints, and quality of life.
      Secondly, participants will be monitored every two weeks for a period of six months following
      CCT/active placebo, allowing the detection of potential relapse of depression. Thirdly, the
      investigators will assess participant evaluation of the addition of cognitive remediation to
      ECT using qualitative interview methods (satisfaction, acceptability and appropriateness).
      Finally, in order to further advance our understanding of the mechanisms underlying effects
      of CCT, exploratory analyses may be conducted using facial video footage collected during the
      CCT/active control phase of the study.
    

Intervention name(s): Cognitive Control Training; Active Control
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Cognitive Control Training (CCT) makes use of a very basic cognitive task that strongly loads on working memory and cognitive control processes, namely the adaptive Paced Auditory Serial Addition Task (aPASAT) where participants are given a number every 3 seconds and are asked to add the number they just heard with the number they heard before. Task difficulty is modified based on the participants current task performance, allowing training of cognitive control. Participants in the intervention group will start the CCT training after completion of ECT with a maximum time interval of 7 days. Training sessions will be performed on a tablet or computer and participants will complete five sessions per week (20 minutes per session) for a period of two weeks.; Participants in the active control group will start placebo training after completion of ECT with a maximum time interval of 7 days. The placebo task consists of a task similar to the experimental condition but that does not train cognitive control. Prior research confirmed that this condition controls for non-specific effects of the training and motivational issues. Participants will perform the sessions on a tablet or computer and complete five sessions per week (20 minutes per session) for a period of two weeks.
Other intervention name(s): aPASAT
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participants will be assigned to either intervention or placebo.
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Cognitive control training