Somatics Thymatron System IV User Manual page 19

Thymatron System IV Instructions for Use
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retesting at this follow-up. There were no statistically significant changes from baseline to 6 months post-ECT in
any of the neuropsychological assessments (visual memory, verbal memory, delayed recall, and executive
function). In examinations of patient-level data, cognition significantly improved in 14% of patients and
significantly declined in 12%.
In a series of 81 elderly depressed patients treated with a Thymatron® System IV device, Mini-Mental State
Examination scores were not below pretreatment levels one week post-ECT, although some had preexisting
brain atrophy (Oudega et al., 2014). In another series of 65 similarly treated elderly patients, deficits in executive
function and processing speed appeared only transiently (Dybedal et al., 2016).
Schat et al (2007) used a Thymatron® DGx ECT device to treat 83 DSM-IV medication-free patients with
unipolar depression who had been evaluated at baseline on tests of behavioral (everyday) and semantic memory.
One year after a course of bilateral or unilateral ECT, neither everyday nor semantic memory scores were
reduced from baseline; bilateral ECT was associated with significantly improved semantic memory scores.
Other studies have reported that cognitive performance after ECT with a Thymatron® device exceeded
pretreatment performance. In a group of 31 patients with major depressive disorder assessed prior to and 6 weeks
after non-standardized ECT, large improvements were found six weeks after ECT in processing speed,
attention/vigilance, and visual learning, with other cognitive domains not changed from baseline (Mohn & Rund,
2016).
Smith GE et al (2010) conducted a randomized controlled trial in unipolar major depressives, comparing
multiple memory test effects after 12 and 24 weeks of ECT with the Thymatron® System IV device and
pharmacotherapy with a nortriptyline-lithium combination. Twelve-week objective anterograde memory scores
and 24-week subjective memory scores were significantly improved for both treatment groups compared with
baseline. There were no clinically significant memory outcome differences between ECT and drug therapy for
depression.
van Oostrom et al (2018) studied 19 medication-free treatment-resistant major depressives. They underwent a
whole-brain magnetic resonance imaging scan and a neuropsychological examination one week before and
within 1 week after the course of ECT with a Thymatron® System IV device. With ECT, hippocampal volumes
increased significantly. This increase correlated with a decrease in cognitive functioning. Bouckaert et al (2016)
reported that such increases are transient.
Verwijk et al (2014) assessed global cognitive function, memory, and executive functions in 42 depressed
patients before and one week and 6 months after courses of ECT administered with a Thymatron® System IV
device. There was no decline for any of the neurocognitive tests after ECT. Medium to large post-ECT
improvements in neurocognitive functioning one week post-ECT were statistically significant for the Mini-
Mental State Examination, Visual Association Test, 10 Words Verbal Learning Test, and Expanded Mental
Control Test.
Ziegelmayer C et al (2017) examined neurocognitive performance in a sample of 20 treatment-resistant ECT-
naive depressed subjects. Cognitive functioning was assessed at baseline, 1 week, and 6 months after 12 to 15
unilateral ECTs with a Thymatron® System IV device. No adverse effects were observed in any of the cognitive
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