Fine-tuning electroconvulsive therapy: A cognitive comparison of brief and ultra-brief pulse widths
Background: Electroconvulsive therapy (ECT) has been a cornerstone in managing severe psychiatric illnesses. However, concerns about its cognitive side effects have led to evolving techniques aimed at minimizing cognitive impairments. Specifically, the use of ultra-brief pulse width (0.5 ms) compare...
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Manipal College of Medical Sciences, Pokhara
2025-07-01
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| Series: | Asian Journal of Medical Sciences |
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| Online Access: | https://ajmsjournal.info/index.php/AJMS/article/view/4569 |
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| author | Vishesh Yadav Abhishek Pathak Rahul Singh Jaymin Maganbhai Pandav Divya Kushwaha Manish Singh Yogi Rana |
| author_facet | Vishesh Yadav Abhishek Pathak Rahul Singh Jaymin Maganbhai Pandav Divya Kushwaha Manish Singh Yogi Rana |
| author_sort | Vishesh Yadav |
| collection | DOAJ |
| description | Background: Electroconvulsive therapy (ECT) has been a cornerstone in managing severe psychiatric illnesses. However, concerns about its cognitive side effects have led to evolving techniques aimed at minimizing cognitive impairments. Specifically, the use of ultra-brief pulse width (0.5 ms) compared to brief pulse width (1.5 ms) in bitemporal modified ECT (MECT) offers a promising avenue for cognitive preservation.
Aims and Objectives: To compare the cognitive outcomes associated with brief and ultra-brief pulse widths in bitemporal MECT.
Materials and Methods: This prospective, randomized comparative study was conducted at a rural tertiary care hospital in Northern India. Sixty-six patients aged 18–60 years, diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder, or severe depression, were randomly assigned to receive either brief or ultra-brief pulse MECT. Cognitive functions were assessed using standardized tools, including the Hindi mental status examination and Battery for ECT-related cognitive deficits. Pre- and post-treatment evaluations were compared to determine changes in cognitive performance.
Results: Both groups exhibited some level of cognitive change following treatment. However, patients receiving ultra-brief pulse MECT demonstrated significantly better preservation of cognitive functions, notably in memory retention, attention, and executive functioning (P<0.05). Domains such as verbal learning, processing speed, and short-term recall were notably less affected in the ultra-brief group compared to the brief pulse group.
Conclusion: Ultra brief pulse width in bitemporal MECT appears to offer a cognitive advantage over brief pulse width, suggesting it may be the preferred choice when cognitive preservation is a clinical priority. |
| format | Article |
| id | doaj-art-1cf3d4b73b1e450ea50bf431bc836342 |
| institution | DOAJ |
| issn | 2467-9100 2091-0576 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj-art-1cf3d4b73b1e450ea50bf431bc8363422025-08-20T03:16:04ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762025-07-01167145151https://doi.org/10.71152/ajms.v16i7.4569Fine-tuning electroconvulsive therapy: A cognitive comparison of brief and ultra-brief pulse widthsVishesh Yadav 0https://orcid.org/0009-0009-8174-5234Abhishek Pathak 1https://orcid.org/0000-0002-0470-0659Rahul Singh 2https://orcid.org/0000-0002-0592-2499Jaymin Maganbhai Pandav 3https://orcid.org/0009-0002-8042-9191Divya Kushwaha 4https://orcid.org/0009-0000-3689-5668Manish Singh 5https://orcid.org/0009-0000-3649-0708Yogi Rana 6https://orcid.org/0009-0000-7367-1225Postgraduate Resident, Department of Psychiatry, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India Professor and Head, Department of Psychiatry, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India Postgraduate Resident, Department of Psychiatry, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India Postgraduate Resident, Department of Psychiatry, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India Postgraduate Resident, Department of Psychiatry, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India Senior Resident, Department of Psychiatry, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India Postgraduate Resident, Department of Psychiatry, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India Background: Electroconvulsive therapy (ECT) has been a cornerstone in managing severe psychiatric illnesses. However, concerns about its cognitive side effects have led to evolving techniques aimed at minimizing cognitive impairments. Specifically, the use of ultra-brief pulse width (0.5 ms) compared to brief pulse width (1.5 ms) in bitemporal modified ECT (MECT) offers a promising avenue for cognitive preservation. Aims and Objectives: To compare the cognitive outcomes associated with brief and ultra-brief pulse widths in bitemporal MECT. Materials and Methods: This prospective, randomized comparative study was conducted at a rural tertiary care hospital in Northern India. Sixty-six patients aged 18–60 years, diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder, or severe depression, were randomly assigned to receive either brief or ultra-brief pulse MECT. Cognitive functions were assessed using standardized tools, including the Hindi mental status examination and Battery for ECT-related cognitive deficits. Pre- and post-treatment evaluations were compared to determine changes in cognitive performance. Results: Both groups exhibited some level of cognitive change following treatment. However, patients receiving ultra-brief pulse MECT demonstrated significantly better preservation of cognitive functions, notably in memory retention, attention, and executive functioning (P<0.05). Domains such as verbal learning, processing speed, and short-term recall were notably less affected in the ultra-brief group compared to the brief pulse group. Conclusion: Ultra brief pulse width in bitemporal MECT appears to offer a cognitive advantage over brief pulse width, suggesting it may be the preferred choice when cognitive preservation is a clinical priority.https://ajmsjournal.info/index.php/AJMS/article/view/4569electroconvulsive therapy; cognitive adverse effects; pulse duration; ultra brief pulse; modified electroconvulsive therapy; cognition disorders |
| spellingShingle | Vishesh Yadav Abhishek Pathak Rahul Singh Jaymin Maganbhai Pandav Divya Kushwaha Manish Singh Yogi Rana Fine-tuning electroconvulsive therapy: A cognitive comparison of brief and ultra-brief pulse widths Asian Journal of Medical Sciences electroconvulsive therapy; cognitive adverse effects; pulse duration; ultra brief pulse; modified electroconvulsive therapy; cognition disorders |
| title | Fine-tuning electroconvulsive therapy: A cognitive comparison of brief and ultra-brief pulse widths |
| title_full | Fine-tuning electroconvulsive therapy: A cognitive comparison of brief and ultra-brief pulse widths |
| title_fullStr | Fine-tuning electroconvulsive therapy: A cognitive comparison of brief and ultra-brief pulse widths |
| title_full_unstemmed | Fine-tuning electroconvulsive therapy: A cognitive comparison of brief and ultra-brief pulse widths |
| title_short | Fine-tuning electroconvulsive therapy: A cognitive comparison of brief and ultra-brief pulse widths |
| title_sort | fine tuning electroconvulsive therapy a cognitive comparison of brief and ultra brief pulse widths |
| topic | electroconvulsive therapy; cognitive adverse effects; pulse duration; ultra brief pulse; modified electroconvulsive therapy; cognition disorders |
| url | https://ajmsjournal.info/index.php/AJMS/article/view/4569 |
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