Many ECT recipients report problems with access to testing for brain injury. Cellular damage caused by repetitive mild traumatic brain injury from high field strength electrical trauma cannot be captured on standard scans. How do you know which test is right to identify memory loss and learning difficulties caused by electroconvulsive therapy (ECT) or Shock therapy? Frequently ECT recipients are referred for Neuropsych testing, but not every test will detect problems caused by ECT. Many psychologists are not familiar with ECT research outcomes to correctly identify which tests are most sensitive to measuring changes. Knowing which tests will be most sensitive to the deficits caused by ECT can be challenging when unfamiliar with ECT research and treatment outcomes.
According to Somatics, LLC (ECT device manufacturer), ECT potentially causes problems with memory, executive functioning, vision disturbances, auditory disturbances, motor dysfunction, seizures, cardiac arrhythmias, etc). Some changes may only be subtle if assessments are not sensitive or given correctly. This is the first in the series of posts to help people get comprehensive appropriate testing. (Until I’ve completed the other posts on appropriate assessments, you can find a summary here.)
In a study entitled “Diminution of Anterograde Amnesia Following Electroconvulsive Therapy” Researchers (Squire and Miller) demonstrate how ECT recipients typically experience severe anterograde memory loss (inability to remember new information) and the inability to create new memories. Some people are inaccurately told “ECT will improve memory.” Doctors who say this are basing their information on research where ECT recipients had their memory tested within hours after ECT. In those studies, it appears to improve–but improvements aren’t lasting. Squire and Miller demonstrated that by testing three hours after ECT and also 24 hours after learning material. 24 hours later, only 3.9% of what the person originally “learned” was retained. This is an important distinction for accurately testing ECT memory loss.
Doctors unfamiliar with this research may blame memory and learning problems on the original diagnosis, (usually depression). Squire and Miller considered that too and decided to compare memory and learning in people who had ECT with people who had the same diagnoses but no history of ECT. They discovered that people who never had ECT, but who lived with mental illness scored at 77% on the memory tests. People with a history of ECT scored at 33%, a highly significant difference. Appropriate testing identifies that anterograde memory loss and the inability to retain new information is caused by ECT.
Squire and Miller say the most sensitive way to test memory problems with ECT is by delayed testing–not testing within minutes or hours of learning information. This can be confusing for people less familiar with accurately testing the type of memory loss experienced by ECT recipients who will assume that if a person can recall information within 30 minutes or three hours, that they have “learned” or can retain the information. This conclusion underestimates the realities of memory loss experienced by ECT recipients by not completing accurate testing.
This research explains how inaccurate assessments wrongly conclude minimal problems with memory and the ability to create new memories. ECT recipients deserve appropriate assessments and comprehensive rehabilitation as indicated by appropriate testing. Since the US FDA approved ECT for use on children 13 and older, this study is especially important for kids and young adults in school who need to qualify for academic accommodations using IEP or 504 Plans. Appropriate testing can also help people gain access to appropriate employment accommodations.
If you or a loved one is going to be completing neuropsych testing to assess for cognitive changes after ECT, bring this study (and this summary of other appropriate tests) with you to assist psychologists in correctly identifying which tests will properly assess ECT treatment outcomes. Please help break barriers to accessing appropriate comprehensive brain injury assessments for ECT recipients by clicking here to sign our international petition.
Self-advocacy while living with repetitive mild traumatic brain injury can be challenging. The more you know, the better you can advocate. Getting the right tests can qualify ECT recipients for rehabilitation and other benefits as indicated. Appropriate services improves quality of life after ECT.