Electroconvulsive therapy with a memory reactivation intervention for post-traumatic stress disorder: A randomized controlled trial
Victor M Tang, Kathleen Trought, Kristina M Gicas, Mari Kozak, Sheena A Josselyn, Zafiris J Daskalakis, Daniel M Blumberger, Daphne Voineskos, Yuliya Knyahnytska, Suvercha Pasricha, Yuan Chung, Young Zhou, Moshe Isserles, Albert H C Wong, Victor M Tang, Kathleen Trought, Kristina M Gicas, Mari Kozak, Sheena A Josselyn, Zafiris J Daskalakis, Daniel M Blumberger, Daphne Voineskos, Yuliya Knyahnytska, Suvercha Pasricha, Yuan Chung, Young Zhou, Moshe Isserles, Albert H C Wong
Abstract
Background: Post-traumatic Stress Disorder (PTSD) often does not respond to available treatments. Memories are vulnerable to disruption during reconsolidation, and electroconvulsive therapy (ECT) has amnestic effects OBJECTIVE/HYPOTHESIS: To test the use of ECT to disrupt the reconsolidation of traumatic memories as a potential treatment for PTSD METHODS: Participants were adults from the civilian population and were referred for ECT treatment for severe depression with comorbid PTSD symptoms. Twenty-eight participants were randomly assigned to reactivation of a traumatic or non-traumatic memory using audio script driven imagery prior to each ECT treatment. Primary outcomes were change in scores on the Modified PTSD Symptom Scale - Self Report (MPSS-SR) and the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Secondary outcomes included a comparison of the change in heart rate while listening to the script RESULTS: Twenty-five female patients who completed a post-ECT assessment were included in the analysis. No significant group differences were found in the MPSS-SR or CAPS-5 scores from pre-ECT to post-ECT or 3-month follow-ups. However, both groups improved at post-ECT and 3-month follow up. Partial eta squared estimates of effect size showed large effect sizes for all outcomes (η2 > 0.13). Changes in heart rate were not significantly different between groups or over time CONCLUSIONS: ECT paired with pre-treatment traumatic memory reactivation was not more effective for treating PTSD symptoms than ECT with non-traumatic memory reactivation. While our primary hypothesis was not supported, our data provides further support for the efficacy of ECT for improving symptoms of PTSD with comorbid depression. ClinicalTrials.gov. https://ichgcp.net/clinical-trials-registry/NCT04027452.
Identifier: NCT04027452.
Keywords: Electroconvulsive therapy; Imagery; Memory; Post-traumatic stress disorder; Reconsolidation; Stress disorders.
Conflict of interest statement
Declaration of competing interest Dr. Tang, Ms. Trought, Dr. Gicas, Dr. Kozak, Dr. Josselyn, Dr. Knyahnytska, Dr. Chung, Mr. Zhou, Dr. Isserles and Dr. Wong have no biomedical financial interests or potential conflicts of interest. Dr. Daskalakis reports grants from Brainsway Inc, grants from Magventure Inc, grants from Ontario Mental Health Foundation, outside the submitted work. Dr. Blumberger reports non-financial support from Brainsway and Magventure, grants from CIHR, Brain Canada, and NIH, outside the submitted work. Dr. Voineskos reports grants from the Ontario Mental Health Foundation, from the Innovation Fund of the Alternate Funding Plan for the Academic Health Sciences Centres of Ontario, outside the submitted work.
Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.
Source: PubMed