Abstract
Background: Elevated glucocorticoids may increase the vulnerability of the brain to
the adverse effects of repeated seizures. This study tested the hypothesis that higher
ambient cortisol levels would predict increased cognitive impairment in depressed
patients subsequent to receiving electroconvulsive therapy (ECT) for major depression.
Methods: Sixteen subjects provided three samples of saliva the day before receiving
unilateral nondominant ECT. Measures of mood, global cognitive functioning, attention,
executive function, verbal and visuospatial memory, and visuospatial processing speed
were obtained 1 day before the first ECT and 1 day after the sixth ECT treatment.
The relationship between basal salivary cortisol obtained before the first ECT treatment
and the change score of each cognitive measure after the sixth ECT treatment was examined
and tested with Pearson correlation coefficients.
Results: Electroconvulsive therapy treatments delivered over 2 weeks resulted in a
significant improvement in mood and a decline in most measures of cognitive performance.
Elevated basal cortisol was associated with a greater decline in performance of executive
function, visuospatial processing speed, and verbal memory.
Conclusions: Although this study is limited by the small number of subjects and the
high number of comparisons, all significant correlations were consistent with the
hypothesis that elevated cortisol predicts a greater degree of ECT-induced cognitive
impairment.
Keywords
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Article info
Publication history
Accepted:
February 2,
2001
Received in revised form:
January 31,
2001
Received:
September 11,
2000
Identification
Copyright
© 2001 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
