Remote Ischemic Preconditioning in Decreasing Post-Electroconvulsive Therapy-Induced Cognitive Dysfunction

Keywords

RIPC - ECT - ASA

Introduction: Ischemic injury has been implicated in causing post-electroconvulsive therapy (ECT) cognitive dysfunction. Remote ischemic preconditioning (RIPC) causes nonlethal ischemia on a limb, which results in protection of distant organ from ischemic injury. Hence, we studied the role of RIPC in decreasing post-ECT cognitive dysfunction.

Methodology/Description: The study was conducted on 80 patients after obtaining their informed consent and ethics committee approval. Patients 18 to 65 years of age, of either gender with a diagnosis of schizophrenia and ASA 1 to 2, were included. The patients were randomized into two groups. The intervention group received RIPC and the control group received sham RIPC before each ECT session for six such ECTs. The RIPC protocol included three 5-minute cycles of upper limb ischemia inflated to a cuff pressure of 30 mm Hg above the systolic BP with 5 minutes intervals of reperfusion in between. The cuff in the control group was inflated to a pressure of 30 mm Hg only. The cognitive assessment was done before the first and after the sixth ECT. Mann–Whit-ney U test, ANOVA, and paired t-test were used for analysis of data.

Results: There was no significant statistical difference in the cognitive and memory assessment scores of HMSE test (p = 0.908), PGI memory scale test (p = 0.123), B4ECT ReCODE test (p = 0.308) both within and in between the two groups.

Conclusion: RIPC has not been found effective in preventing cognitive and memory impairment post-ECT in schizophrenia patients.

• References

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