Article ; Online: Effect of erythropoietin on cognitive side-effects of electroconvulsive therapy in depression: A randomized, double-blind, placebo-controlled trial.
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
2023 Volume 79, Page(s) 38–48
Abstract: Electroconvulsive therapy (ECT) is one of the most effective and rapid-acting treatment for severe depression but is associated with cognitive side-effects. Identification of add-on treatments that counteract these side-effects would be very helpful. ... ...
| Abstract | Electroconvulsive therapy (ECT) is one of the most effective and rapid-acting treatment for severe depression but is associated with cognitive side-effects. Identification of add-on treatments that counteract these side-effects would be very helpful. This randomized, double-blinded, placebo-controlled, parallel-group study investigated the effects of four add-on erythropoietin (EPO; 40,000 IU/ml) or saline (placebo) infusions over 2.5 weeks of ECT (eight ECT sessions) in severely depressed patients with unipolar or bipolar depression. Neuropsychological assessments were conducted pre-ECT, three days after the eighth ECT (week 4), and at a 3-month follow-up. Further, functional magnetic resonance imaging (fMRI) was conducted after the eighth ECT. The primary outcome was change from pre- to post-ECT in a 'speed of complex cognitive processing' composite. Secondary outcomes were verbal and autobiographical memory. Of sixty randomized patients, one dropped out before baseline. Data were thus analysed for 59 patients (EPO, n = 33; saline, n = 26), of whom 28 had fMRI data. No ECT-related decline occurred in the primary global cognition measure (ps≥0.1), and no effect of EPO versus saline was observed on this outcome (ps≥0.3). However post-ECT, EPO-treated patients exhibited faster autobiographical memory recall than saline-treated patients (p = 0.02), which was accompanied by lower memory-related parietal cortex activity. The absence of global cognition changes with ECT and EPO, coupled with the specific impact of EPO on autobiographical memory recall speed and memory-related parietal cortex activity, suggests that assessing autobiographical memory may provide increased sensitivity in evaluating and potentially preventing cognitive side-effects of ECT. TRIAL REGISTRATIONS: ClinicalTrials.gov: NCT03339596, EudraCT no.: 2016-002326-36. |
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| MeSH term(s) | Humans ; Electroconvulsive Therapy/adverse effects ; Electroconvulsive Therapy/methods ; Depression ; Treatment Outcome ; Erythropoietin/therapeutic use ; Erythropoietin/pharmacology ; Epoetin Alfa ; Cognition ; Double-Blind Method | ||||||||||
| Chemical Substances | Erythropoietin (11096-26-7) ; Epoetin Alfa (64FS3BFH5W) | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2023-12-20 | ||||||||||
| Publishing country | Netherlands | ||||||||||
| Document type | Randomized Controlled Trial ; Journal Article | ||||||||||
| ZDB-ID | 1082947-7 | ||||||||||
| ISSN | 1873-7862 ; 0924-977X | ||||||||||
| ISSN (online) | 1873-7862 | ||||||||||
| ISSN | 0924-977X | ||||||||||
| DOI | 10.1016/j.euroneuro.2023.12.004 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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