Original ArticlesElectrophysiological Correlates of the Adverse Cognitive Effects of Electroconvulsive TherapySackeim, Harold A. Ph.D*; Luber, Bruce Ph.D; Moeller, James R. Ph.D; Prudic, Joan M.D; Devanand, D. P. M.D; Nobler, Mitchell S. M.DAuthor Information Departments of Biological Psychiatry, New York State Psychiatric Institute, New York; and the Departments of Psychiatry and *Radiology, College of Physicians and Surgeons, Columbia University, New York, New York, U.S.A. Received February 22, 1999; accepted January 11, 2000. Address correspondence and reprint requests to Dr. H. A. Sackeim, Department of Biological Psychiatry, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, U.S.A. The Journal of ECT: June 2000 - Volume 16 - Issue 2 - p 110-120 Buy Abstract Resting state, eyes closed, 19-lead EEG recordings were obtained at pre-ECT baseline and just prior to penultimate treatment and during the week following the ECT course in 59 patients with major depression. Patients had been randomized to ECT conditions that varied in electrode placement and stimulus intensity. The EEG data were submitted to power spectral analysis, and global and topographic effects were characterized for the delta and theta frequency bands. Relations between the EEG changes and scores on three cognitive measures were examined. The period of disorientation immediately following RUL ECT was associated with an accentuation of delta power in anterior frontal and temporal regions. Across the electrode placements, increased theta activity in left frontotemporal regions was associated with longer recovery of orientation. Post-ECT decrements in global cognitive status, as assessed by the modified Mini-Mental State exam, were associated with a greater increase in delta relative to theta power, globally across the cortex. The magnitude of retrograde amnesia for autobiographical events correlated with increased theta activity in left frontotemporal regions. The findings suggest that distinct neurophysiological changes subserve the therapeutic and adverse cognitive effects of ECT. Postictal disorientation and post-ECT retrograde amnesia appear to share a common physiological substrate. © 2000 Lippincott Williams & Wilkins, Inc.