A Randomized Study Comparing the Short-Term Neurocognitive Outcome of Electroconvulsive Therapy Versus Repetitive Transcranial Magnetic Stimulation in the Treatment of Patients With Depression


Journal of Psychiatric Practice. 26(1):23-36, 2020 01.

Abdel Latif A; Nasreldin M; Abdel Kader A; Fathy H; Moussa S; Basheer M; Elsheikh A; Madbouly N

Studies have compared electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) with regard to their clinical efficacy in the treatment of depression, but only a few studies have addressed their differential impact on cognition. The purpose of this study was to compare the neurocognitive side effects of both treatment modalities.

In this comparative study, 40 patients with major depressive disorder referred for ECT were randomly assigned either to a course of 25 sessions of rTMS to the left dorsolateral prefrontal cortex or to a course of ECT ranging from 4 to 8 sessions. The primary outcome measures were the results of a cognitive battery that assessed different aspects of cognitive functioning. The cognitive battery comprised the Digit Span Subtest from the Wechsler Adult Intelligence Scale, the Stroop Color-Word Test-Victoria version, the Color Trails Test Trials 1 and 2, and the Rey-Osterrieth Complex Figure Test.

At the end of treatment, scores on the Digit Span Subtest, the Stroop Color-Word Test-Victoria version, and the Color Trails Test showed statistically significant better results in the rTMS group compared with the ECT group.

rTMS was well tolerated with less negative impact on cognitive functioning than ECT.