Ect long term memory loss

The long-term impact of treatment with electroconvulsive therapy on discrete memory systems in patients with bipolar disorder

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[Doctor, will I get my memory back? Electroconvulsive therapy and cognitive side-effects in daily practice]

. 2017;59(10):632-637.

[Article in Dutch]

E Verwijk, J Obbels, H P Spaans, P Sienaert

  • PMID: 29077139

Free article

[Article in Dutch]

E Verwijk et al. Tijdschr Psychiatr. 2017.

Free article

. 2017;59(10):632-637.


E Verwijk, J Obbels, H P Spaans, P Sienaert

  • PMID: 29077139


Background: Patients undergoing or about to undergo electroconvulsive therapy (ECT) are often afraid they will experience negative cognitive side-effects.

Aim: To answer questions that patients and referring clinicians often ask about cognitive problems that can result from ECT.

Method: To discuss, on the basis of clinical perception and literature, the cognitive problems resulting from ECT.

Results: The cognitive problems resulting from ect are threefold: short-term postictal confusion (immediately after the treatment), anterograde amnesia and retrograde amnesia. A patient affected by anterograde amnesia, is temporarily less able to remember what he or she has experienced over a period of three months after treatment. The brain of a patient with retrograde amnesia is unable to retrieve or remember information or procedures 'saved' before the treatment took place. More specifically the patient with retrograde amnesia has three main types of problems: semantic memory problems (relating to facts), episodic memory problems (no longer able to retrieve memories concerning non-personal events), and procedural memory problems (no longer able to operate various devices). It is difficult to predict which patients will experience cognitive problems as a result from ect and to what extent. However, the problems are not intensified by maintenance treatment. Factual and autobiographical memory problems following ect-induced retrograde amnesia seems to have a more permanent character. According to the Dutch guidelines for ECT, cognitive side-effects need to be monitored. If patients are monitored before and after ect, they can be given a more targeted psycho-education and eventually a more targeted training course.

Conclusion: We conclude that in clinical practice increasing attention is being given to ECT-related cognitive side-effects. Clearly, however, more consideration needs to be given to inter-individual variability. Cognitive monitoring is advisable because the course of the side-effects of ect must be followed and evaluated.

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MeSH terms

Fundamental Guide to Know

Our brains use different structures to deal with existing types of memory. There are two main types of memory: short-term memory and long-term memory. Although dysfunctions of both types of memory are possible, we will focus on Long-Term Declarative Memory.

  • Short-term memory stores a limited amount of information for a short period of time.
  • Long-term memory stores a large amount of complex information for a long time. This is what is usually called "memory". In turn, there are two types of Long-term memory: Non-declarative or Implicit Memory (cycling, driving) and Declarative or Explicit memory, used to remember our personal experience or knowledge about the world (what is the name of my relative, where I left clues as to who is in charge of my country, what happened five minutes or five months ago).

What is memory loss and symptoms

When we forget something, we usually don't "lose" the memory itself, but our brain "can't find a way" to what we're trying to remember. This "pathological" loss of memory is called amnesia. Here are some symptoms of memory loss:

  • Often lose personal items.
  • It's hard to find the right words.
  • Asking repeated questions in a conversation or telling the same story over and over.
  • Forgetting whether or not you have done something, such as taking medicine.
  • Become disoriented or lost in familiar places.
  • Confuse year or day of the week.
  • Forget about meetings or events.
  • Having difficulty making decisions or following instructions.

Types of memory loss: Transient and Permanent

Memory loss can manifest itself in two forms: temporary (transient) and permanent (permanent) memory loss.

  • Transient or temporary memory loss is a temporary forgetting of information that is restored in our memory after a while. If we cannot remember the name but then remember it an hour later, or if we wake up in the morning and cannot remember what happened the night before after drinking alcohol, this is considered a temporary memory loss.
  • Permanent or permanent memory loss is information that we lose and cannot recover. If we fail to remember, even if we are reminded of it by the other person where we left the keys to the house, or if we forget about the meeting with the brother made the night before, we are dealing with permanent memory loss.

Causes of memory loss: medical, emotional and age-related problems

There are several factors that can lead to involuntary memory loss in both young and old age. Many of these factors are not due to poor memory performance, but due to the interference of other cognitive abilities (such as attention) or certain substances (such as drugs).

  • Memory loss due to health problems which, in most cases, are treatable: side effects of certain medications, an unbalanced diet with a reduced content of vitamins B6, B9 and B12 can lead to temporary memory loss, alcohol abuse, thyroid, kidney or liver diseases, lack of oxygen in the brain (as stroke), the effects of traumatic brain injury (head trauma), cancer treatment (chemotherapy or radiation therapy), brain tumors or infections, emotional problems (such as depression), and anxiety (such as post-traumatic stress).
  • Loss of memory due to stress, anxiety and other emotional problems : In addition, stress, anxiety and some of the consequences of strong emotions such as anger can cause forgetfulness. If we're in a car accident, stress can make us lose our memories of what happened that morning. But typically, these memory losses occur because we focus on threatening stimuli and remove less meaning from our surroundings. Thus, we can remember what caused us these strong emotions, but we cannot recall all the events that occurred during this time. This occurs in the case of Post Traumatic Stress Disorder and Obsessive-Compulsive Disorder. In these disorders, the person is so focused on the emotional episode or object of obsession that he ultimately does not remember anything except for this stimulus.
  • Memory loss with age and normal aging : Although forgetfulness and memory disorders do not occur exclusively in older people, it is true that these people are more susceptible to such problems. With age, the ability to learn and the quality of memory can deteriorate even without the presence of any pathology. However, when these problems become more severe than usual, we may speak of mild cognitive impairment or, in more severe impairments, dementia.
  • Memory loss due to emotional problems in the elderly: It is common for older people to feel lonely when they lose loved ones or not feel useful when they retire. Given these changes, it is normal that some of the older people suffer from emotional disorders such as depression. Depressed older adults may experience feelings of memory loss more often and confuse these symptoms with Alzheimer's disease or other memory problems. Depression can cause serious memory problems in both the elderly and young people, but in the case of older patients, it is very important to conduct an appropriate differential diagnosis in order to rule out the presence of Alzheimer's disease. Although memory problems in people with depression may not be as relevant as in other pathologies, it is necessary to pay attention to the emotional problems that they suffer from.
  • Mild cognitive impairment memory loss: Mild cognitive impairment is a disorder that results in memory loss but does not interfere with the person suffering from it in their daily activities. Some research indicates that mild cognitive impairment may be an early sign of Alzheimer's disease, although these impairments do not lead to Alzheimer's disease in all cases.
  • Memory loss due to dementia is one of the most important health problems affecting the elderly, but it is not a normal consequence of aging. Dementia usually involves the onset of chronic cognitive problems such as problems with memory, speech, behavior, etc. There are various types of dementia, but the most common form is Alzheimer's disease.
  • Memory loss caused by Alzheimer's disease In this disease, a protein called "beta-amyloid" accumulates in neurons, forming senile plaques, until these neurons lose their vitality. This leads to a gradual and severe deterioration in memory, problems with orientation (patients often do not know what day it is and where they are), difficulties in calculations and, in general, with the performance of daily tasks. The severity of the disease varies depending on the stage at which the patient is. In the mild stage, a person with Alzheimer's disease may show significant memory loss, become lost in a familiar place, withdraw from routine activities and conversations, forget dates, and exhibit symptoms of depression and hostility. In the moderate stage, cases of memory loss are most prominent, sufferers may forget names or things that happened a few minutes ago, have difficulty shopping or preparing food, may neglect personal hygiene, have speech problems or show aggression, tend to forget their way, and eventually, their daily life becomes impossible without outside help. In the advanced stage, patients may have problems with eating or understanding simple information, they do not recognize relatives and friends, and behave inappropriately in public. At this stage, the person becomes completely dependent.

Prevention of memory loss

How to prevent memory loss? Factors that have been shown to be most effective in preventing or slowing the progress of Alzheimer's and other memory problems are healthy sleep , proper nutrition , exercise , an active social life and cognitive activity . Our brain functions like a muscle: the more actively we use it, the better its condition will be. Conversely, if our brain is not getting enough nutrition and oxygen through exercise, and if we do not apply our social and cognitive abilities, there will be a tendency to atrophy. For this reason, an active and healthy lifestyle can be very beneficial for our memory. CogniFit offers a wide range of scientifically proven exercises to keep your brain active and improve your cognitive abilities. In addition, cognitive activity not only strengthens memory in adults and the elderly, but can also contribute to the development of intellectual abilities in children and young people.

Cognitive Stimulation allows you to stimulate, train and strengthen various cognitive abilities such as attention, perception, memory, speech and executive functions. These are precisely the abilities that can be impaired in dementia and other diseases associated with memory loss. By doing exercises that involve various cognitive abilities, we help the brain to strengthen neural connections, preventing damage to it. However, cognitive stimulation cannot be random, it needs to be applied with reliable techniques and detailed organization, according to the needs of each patient. CogniFit focuses on personalizing your exercise program to maximize your workouts and help prevent cognitive problems.

In addition, proper sleep patterns and frequent reading help keep your memory in good condition. Of course, it is necessary to give up bad habits associated with the use of alcohol, tobacco or other drugs - this will help strengthen both memory and overall health.

When should you seek help? Detect and evaluate memory problems

It is very common for people with memory problems to be unaware of their existence, so these problems are usually first discovered by their relatives.

On the other hand, people prone to anxiety and depression can dwell on their mistakes. Often they overestimate their forgetfulness, thinking that they have memory problems, but this is far from always the case. If we sometimes suddenly forget the name of an object or the name of a person with whom we usually communicate a lot, or forget why we went to the room or where we left the keys, or forget to take lunch to work - this is not a cause for concern.

However, if the person is having trouble doing daily tasks, or if they seem confused and disoriented, it is time to see a doctor. It is recommended to write down all the information about the course of the impairment: when did the memory problems start, what kind of deterioration was observed, what type of information is forgotten, how it affects daily, social and work life. The attending physician must make an accurate diagnosis and determine whether the patient has memory problems, and if so, what kind of problems they are. When in doubt, it is always best to consult a specialist.

However, short-term episodes of memory loss do not mean that we are talking about serious memory problems, not to mention Alzheimer's disease. We all forget something from time to time, and this is normal (mild memory loss). Our brain has to forget something in order to process new information correctly.

How to treat or reduce memory loss?

Treatment of dementia should be carried out from a multidisciplinary point of view. Depending on 9 the type of disease, the phase in which the patient is, and the specific characteristics of the patient, the involvement of a neurologist, family doctor, internist, geriatrician, psychologist, neuropsychologist, speech therapist, physiotherapist, occupational therapist and nursing staff may be required .

In the case of Alzheimer's disease, the attending physician must develop an appropriate diagnosis and treatment. In addition, exercises for cognitive stimulation of the brain of patients with Alzheimer's disease at an early stage can be included in the treatment program. In more advanced stages, as a rule, other types of treatment are used, including medication. Despite the fact that Alzheimer's disease is currently considered incurable, these drugs are aimed at maintaining the patient's impaired abilities and behavioral problems associated with this disease.

In addition, taking preventive measures can help slow the progression of dementia once the diagnosis is made. Combining drug treatment with proper diet, exercise, social life and cognitive stimulation helps to minimize the effects of dementia in the patient's daily life.

What if a family member has memory loss?

In case of undiagnosed memory problems with a friend of yours, you should recommend 0006 contact specialist . It is normal to receive a rejection of offered care, as many patients are not aware of their problems. Therefore, one should approach this issue with patience and caution .

Once the doctor has made a diagnosis, follow his instructions. If this is a mild stage of the disease, we should help this person to carry out daily tasks both at home and socially. One of the main problems of Alzheimer's disease is temporary disorientation, so it is important to place clocks and calendars in the patient's field of vision. Despite the fact that the disease interferes with the learning process, it is strongly recommended to accustom the patient to use a diary and not reduce the usual volume of tasks. Close people should help him follow the doctor's recommendations, take the pills correctly and carry out the activities associated with the treatment. It can be very difficult for a patient to accept their diagnosis. Therefore, it is very important to him emotional support for loved ones, so that the situation is not perceived so painfully. If symptoms of depression are found, a doctor or psychologist should be informed as soon as possible.

In conclusion:
  • Forgetfulness does not mean the presence of memory problems.
  • It is important to be able to distinguish between the signs of Mild Cognitive Impairment and dementia, such as in Alzheimer's disease, in order to detect them as soon as possible and seek professional help. However, not all memory problems are associated with these disorders, however, they also require medical attention.
  • The impact of Mild Cognitive Impairment and dementia can be reduced through proper nutrition, exercise, adequate rest, socialization and cognitive stimulation.

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Joint order of the Ministry of Taxation of Russia and the Ministry of Health of Russia of July 25, 2001 N 289 / BG-3-04 / 256 (hereinafter - the order of July 25, 2001) approved the form of the Certificate of payment for medical services for submission to the tax authorities of the Russian Federation (hereinafter - the Certificate payment for medical services).

This certificate certifies the fact of receiving a medical service and its payment through the cash desk of a healthcare institution at the expense of the taxpayer.

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