Longitudinal Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Pharmacotherapy in Major Depressive Disorder in Older Adults: Phase 2 of the PRIDE Study.

Autor:	Lisanby SH; Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program (SHL, ZDD), National Institute of Mental Health, National Institutes of Health, Bethesda, MD; Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences (SHL, EB, RDW), Duke University School of Medicine, Durham, NC. Electronic address: Sarah.Lisanby@NIH.gov., McClintock SM; Division of Psychology, Department of Psychiatry (SMM, CMC, MMH), UT Southwestern Medical Center, Dallas, TX., McCall WV; Department of Psychiatry and Health Behavior (WVM, PBR), Medical College of Georgia, Augusta University, Augusta, GA., Knapp RG; Medical University of South Carolina (RGK, MM, AAT), Charleston, SC., Cullum CM; Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences (SHL, EB, RDW), Duke University School of Medicine, Durham, NC., Mueller M; Medical University of South Carolina (RGK, MM, AAT), Charleston, SC., Deng ZD; Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program (SHL, ZDD), National Institute of Mental Health, National Institutes of Health, Bethesda, MD., Teklehaimanot AA; Medical University of South Carolina (RGK, MM, AAT), Charleston, SC., Rudorfer MV; Division of Services and Intervention Research (MVR), National Institute of Mental Health, National Institutes of Health, Bethesda, MD., Bernhardt E; Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences (SHL, EB, RDW), Duke University School of Medicine, Durham, NC., Alexopoulos G; Department of Psychiatry and Behavioral Sciences (GA, VL, RCY), New York Presbyterian/Weill Cornell Medical Center, White Plains, NY., Bailine SH; Department of Psychiatry (SHB, SB, GP), Zucker Hillside Hospital/North Shore-LIJ Health System, New York, NY., Briggs MC; Department of Psychiatry (MCB, ETG, LSL, CHK), Icahn School of Medicine at Mount Sinai, New York, NY., Geduldig ET; Department of Psychiatry (MCB, ETG, LSL, CHK), Icahn School of Medicine at Mount Sinai, New York, NY., Greenberg RM; NYU Langone (RMG), New York, NY., Husain MM; Division of Psychology, Department of Psychiatry (SMM, CMC, MMH), UT Southwestern Medical Center, Dallas, TX., Kaliora S; Department of Psychiatry (SHB, SB, GP), Zucker Hillside Hospital/North Shore-LIJ Health System, New York, NY., Latoussakis V; Department of Psychiatry and Behavioral Sciences (GA, VL, RCY), New York Presbyterian/Weill Cornell Medical Center, White Plains, NY., Liebman LS; Department of Psychiatry (MCB, ETG, LSL, CHK), Icahn School of Medicine at Mount Sinai, New York, NY., Petrides G; Department of Psychiatry (SHB, SB, GP), Zucker Hillside Hospital/North Shore-LIJ Health System, New York, NY., Prudic J; Department of Psychiatry (JP), Columbia University/New York State Psychiatric Institute, New York, NY., Rosenquist PB; Department of Psychiatry and Health Behavior (WVM, PBR), Medical College of Georgia, Augusta University, Augusta, GA., Sampson S; Department of Psychiatry and Psychology (SS), Mayo Clinic, Rochester, MN., Tobias KG; VA New Jersey Health Care System (KGT), East Orange, NJ., Weiner RD; Division of Psychology, Department of Psychiatry (SMM, CMC, MMH), UT Southwestern Medical Center, Dallas, TX., Young RC; Department of Psychiatry and Behavioral Sciences (GA, VL, RCY), New York Presbyterian/Weill Cornell Medical Center, White Plains, NY., Kellner CH; Department of Psychiatry (MCB, ETG, LSL, CHK), Icahn School of Medicine at Mount Sinai, New York, NY.
Jazyk:	angličtina
Zdroj:	The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry [Am J Geriatr Psychiatry] 2022 Jan; Vol. 30 (1), pp. 15-28. Date of Electronic Publication: 2021 May 17.
DOI:	10.1016/j.jagp.2021.04.006
Abstrakt:	Objective: There is limited information regarding neurocognitive outcomes of right unilateral ultrabrief pulse width electroconvulsive therapy (RUL-UB ECT) combined with pharmacotherapy in older adults with major depressive disorder. We report longitudinal neurocognitive outcomes from Phase 2 of the Prolonging Remission in Depressed Elderly (PRIDE) study. Method: After achieving remission with RUL-UB ECT and venlafaxine, older adults (≥60 years old) were randomized to receive symptom-titrated, algorithm-based longitudinal ECT (STABLE) plus pharmacotherapy (venlafaxine and lithium) or pharmacotherapy-only. A comprehensive neuropsychological battery was administered at baseline and throughout the 6-month treatment period. Statistical significance was defined as a p-value of less than 0.05 (two-sided test). Results: With the exception of processing speed, there was statistically significant improvement across most neurocognitive measures from baseline to 6-month follow-up. There were no significant differences between the two treatment groups at 6 months on measures of psychomotor processing speed, autobiographical memory consistency, short-term and long-term verbal memory, phonemic fluency, inhibition, and complex visual scanning and cognitive flexibility. Conclusion: To our knowledge, this is the first report of neurocognitive outcomes over a 6-month period of an acute course of RUL-UB ECT followed by one of 2 strategies to prolong remission in older adults with major depression. Neurocognitive outcome did not differ between STABLE plus pharmacotherapy versus pharmacotherapy alone over the 6-month continuation treatment phase. These findings support the safety of RUL-UB ECT in combination with pharmacotherapy in the prolonging of remission in late-life depression. (Published by Elsevier Inc.)
Databáze:	MEDLINE
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