Elsevier

Biological Psychiatry

Volume 63, Issue 12, 15 June 2008, Pages 1163-1170
Biological Psychiatry

Archival Report
Differential Effects of High-Dose Magnetic Seizure Therapy and Electroconvulsive Shock on Cognitive Function

https://doi.org/10.1016/j.biopsych.2007.11.024Get rights and content

Background

Magnetic seizure therapy (MST) is under investigation as an alternative form of convulsive therapy that induces more focal seizures and spares cortical regions involved in memory. With a newly expanded version of the Columbia University Primate Cognitive Profile, we compared the cognitive effects of high-dose MST delivered at 100 Hz (6 × seizure threshold) with electroconvulsive shock (ECS) delivered at 2.5 × seizure threshold.

Methods

Daily high-dose MST, ECS, and sham (anesthesia-only) were administered for 4 weeks each in a within-subject crossover design. Rhesus macaques (n = 3) were trained on five cognitive tasks assessing automatic memory, anterograde learning and memory, combined anterograde and retrograde simultaneous chaining, and spatial and serial working memory. Acutely after each intervention, monkeys were tested on the cognitive battery twice daily, separated by a 3-hour retention interval.

Results

Subjects were slower to complete criterion tasks (p values < .0001) after ECS, compared with sham and high-dose MST. Moreover, time to task-completion after high-dose MST did not differ from sham. Of six measures of accuracy, treatment effects were found in four; in all of these, ECS but not MST fared worse than sham. On all accuracy and time to completion measurements, subjects performed as well after high-dose MST as subjects from a previous study on moderate-dose MST.

Conclusions

These findings provide evidence that high-dose MST results in benign acute cognitive side-effect profile relative to ECS and are in line with our previous studies.

Section snippets

Subjects

This study was approved by the Institutional Animal Care and Use Committee (IACUC) of the New York State Psychiatric Institute and Columbia University. The subjects were three pathogen-free male rhesus macaca mulatta monkeys obtained from the same National Institutes of Health (NIH) breeding colony. Mean age upon entering the study was 83 (± 26) months, mean weight was 8 (± 1) kg, and all three were past sexual maturity. The approximate age equivalent in human years was 20.8 (± 6.5) years (22,

Feasibility of High-Dose MST Seizure Induction

The MST seizure was induced in all three subjects, and there were no adverse events. The observed MST seizure thresholds were 225 pulses for subject 1, 100 pulses for subject 2, and 300 pulses for subject 3. In the MST condition, there was a mean seizure duration of 24.2 ± 5.3 (SD) sec. This was significantly longer [F(48) = .51, p = .015] than MST seizure duration in the moderate-dose study, where the mean seizure was 19.8 ± 7.4 (SD) sec. However, there was no significant difference between

Discussion

We have shown for the first time that chronic treatment with high-dose MST resulted in less cognitive impairment than ECS (see Table 1 for summary) and that high-dose MST did not significantly differ from the effects of anesthesia alone. Moreover, increasing MST dosage from 2.5 × seizure threshold to 6 × seizure threshold did not impair cognitive performance on most measures. These results support the feasibility and safety of high-dose MST for subsequent work in humans to assess its efficacy

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