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Retrograde Amnesia and Bilateral Electroconvulsive Therapy

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Title: Retrograde Amnesia and Bilateral Electroconvulsive Therapy


1
Retrograde Amnesia and Bilateral
Electroconvulsive Therapy
  • Long Term and Follow-up

Squire, Slater, Miller (1981)
Summarized by Bobbie Perkins
2
Introduction
  • Electroconvulsive therapy (ECT)
  • small, carefully controlled amount of electricity
    is introduced into the brain.
  • used in conjunction with anesthesia and muscle
    relaxant medications
  • produces a mild generalized seizure or convulsion
  • most effective in the treatment of severe
    depression
  • Bilateral ECT is when electrodes are placed on
    both sides of the head.

3
Introduction
  • ECT is sometimes used as a treatment for severe
    depression.
  • Memory loss is one prominent side effect of
    electroconvulsive therapy.
  • Most patients will report some retrograde amnesia
    for events that preceded ECT.
  • Memory functions generally improve after
    treatment is completed.
  • Forgetting may be due to pretreatment depression,
    antidepressant drugs, or the unreliability of
    informal reports.

4
Methods
  • 4 groups (43 psychiatric inpatients)
  • ETC patients
  • Control group (7 inpatients)
  • None of the patients in the control group was
    receiving ECT and none had received it in the
    past.
  • In the experimental group 12 of the 43 patients
    had received ECT before but not within the
    previous 12 months.
  • The patients psychiatrists determined the number
    of treatments and prescriptions of psychotropic
    drugs during and after ECT.

5
Methods
  • ECT was administered 3 times a week on alternate
    days after medication with atropine sulfate,
    methohexital sodium and succinylcholine chloride.
  • Treatments were given with 140 to 170 V for 0.5
    to 1.0 s.
  • Electrode placement was bitemporal
  • In all cases the attending physician reported
    that the current produced a grand mal seizure.

6
Methods
  • 4 different tests
  • Public events recognition
  • Public events recall
  • Recall of television programs
  • Recall of personal events

7
Methods
  • Previous studies have indicated that memories
    acquired a few years prior to ECT can be lost
    without the disturbance of older memories.
  • On test 4
  • 1st six questions dealt with remote past
  • Last 3 dealt with recent past
  • 8th question events that were 6 to 37 months old
  • 9th question events 14 to 19 months old
  • 10th question events 2 to 36 days old
  • The results for the 7th question were excluded

8
Methods
  • Repeated testing
  • Some subjects took tests 1-4 on two or more
    occasions
  • Considered that performance may noticeably
    improve
  • Gave tests 1 and 2 to control subjects and scores
    were slightly improved but it doesnt seem like
    the ECT patients could have benefited from
    repeated testing.

9
Results
10
Results
11
Results
12
Results
  • For test 4 they also used a reminding procedure.
  • When previously recalled information was omitted
    it was presented to the patients and asked if it
    was familiar.
  • 2nd interview ECT patients needed more reminders
    then control patients.
  • 3rd interview ECT patients needed reminders as
    often as control patients.
  • Control patients the reminding procedure was
    effective 100 of the time.
  • ECT patients the reminding procedure was
    effective only 71 of the time.
  • Failure to recognize material when reminders were
    provided was considerably more frequent for
    recent events than for more remote events.

13
Discussion
  • It was found that long lasting subtle amnesias
    can occur after a course of 8-9 ECT treatments,
    and the amnesias are most prominent for the
    period just prior to treatment.
  • This supported what Janis found in her study.
  • Janis hypothesized that ECT affected the
    retrieval process reducing access to certain
    memories.
  • Squire suggested that ECS may affect both
    retrieval of already stored memories and their
    continued consolidation.
  • The return of supposedly forgotten memories
    supports the retrieval-failure hypothesis.
  • The persistent loss for other memories suggests
    that some material in long-term store is still
    susceptible to disruption.

14
References
  • Squire, Slater, Miller. (1981). Retrograde
    Amnesia and Bilateral Electroconvulsive Therapy.
    Archives of General Psychiatry, 89-95.
  • Terry, W. S. (2003). Human Memory Conceptual
    Approaches. Learning and Memory Basic
    Principles, Processes, and Procedures, 193-229.
  • Barstow, Donald. Electroconvulsive Therapy.
  • http//www.ehendrick.org/healthy/000468.htm
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