Table 45Impact on cognitive functioning of ECT versus rTMS: Tier 1, MDD

Author, Year
Design
Endpoint
Quality
Intervention and Sample Size
Study Details
Outcomes
Rosa et al, 200658
RCT
Primary endpoint was after up to 4 weeks of active treatment
Fair
ECT (n = 20)
% bilateral NR, mean
sessions 10 (SD 1.5)
rTMS (n = 22)
High frequency, 10-20
sessions (2-4 weeks)
WAIS-R, subsections of WMS (digit span) and RBMT;:
ECT vs. rTMS: no significant differences
Schulze-Rauschenbach et al., 2005123
Prospective cohort Outcomes measured 8.8 days on average after last treatment
Fair
ECT (n = 14)
Right unilateral txt for 2 weeks
rTMS (n = 16)
High frequency, mean 10.8
sessions (SD 1.4)
Learning and Anterograde Memory with AVLT:
Recall after interference:
Before treatment
ECT: 2.8 (2.2) vs. rTMS: 3.2 (1.9)
1 week after treatment
ECT: 3.9 (1.9) vs. rTMS: 1.8 (2.0), P < 0.01
Recall after delay:
Before treatment
ECT: 2.4 (1.8) vs. rTMS: 3.2 (1.6)
1 week after treatment
ECT: 4.2 (1.6) vs. rTMS: 2.4 (2.0), P < 0.05
Other AVLT subscales or the Memory for Persons Test (MPT):
No significant differences
Retrograde memory with AVLT
Recall:
No difference on recall or recognition hits
Recognition false alarms
1 week after treatment:
ECT: 5.0 (3.0) vs. rTMS: 1.1 (1.1), P < 0.05
Four-card task - Free recall:
1 week after treatment
ECT: 0.4 (0.5) vs. rTMS: 1.4 (1.2), P < 0.05
Subjective memory with SSMQ:
Before treatment
ECT: -20.7 (19.0) vs. rTMS: -16.8 (16.9)
1 week after treatment
ECT: -15.2 (25.2) vs. rTMS: 3.8 (11.8), P < 0.05

AVLT = Auditory Verbal Learning Test; ECT = electroconvulsive therapy; MPT = memory persons test; n = number; NR = not reported; pt = patient; RCT = randomized controlled trial; rTMS = repetitive transcranial magnetic stimulation; SSMQ = Squire Subjective Memory Questionnaire; txt = treatment; vs. = versus; WAIS-R = Weschler Adult Intelligence Scale-Revised; WMS = Weschler Memory Scale

From: Results

Cover of Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults
Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults [Internet].
Comparative Effectiveness Reviews, No. 33.
Gaynes BN, Lux LJ, Lloyd SW, et al.

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