Remote Ischemic Preconditioning Does Not Alleviate Post-Electroconvulsive Therapy Cognitive Dysfunction

J ECT. 2025 Apr 15. doi: 10.1097/YCT.0000000000001150. Online ahead of print.

Abstract

Objective: This study aimed to evaluate the efficacy of remote ischemic preconditioning in decreasing post-electroconvulsive therapy-induced cognitive dysfunction.

Methods: This was a randomized controlled clinical trial in patients with schizophrenia. The patients recruited in the study were subjected to RIPC or sham RIPC. RIPC or sham RIPC was given before each ECT, and the patient was followed up with six ECTs. The cognitive and memory assessments before and after ECT within and between the groups were compared via the Hindi Mental State Examination (HMSE), Battery for Electroconvulsive Therapy-Related Cognitive Deficits (B4ECT ReCoDe), Clinical Global Impression-Severity Index (CGI-SI), and PGI Memory Scale (PGI).

Results: The sociodemographic and clinical profiles were similar between the groups. The HMSE (P = 0.824), B4ECT ReCoDe (P = 0.225), PGI (P = 0.111), and CGI-S (P = 0.776) scores were not significantly different between the groups.

Conclusions: Remote ischemic preconditioning was not successful in decreasing post-cognitive dysfunction in patients with schizophrenia who were receiving electroconvulsive therapy. However, it was safe and feasible in ECT patients and did not have any significant effect on the primary disease.

Keywords: RIPC; cognition; electroconvulsive therapy; schizophrenia.