Hihn Hermina, Baune Bernhard T, Michael Nikolaus, Markowitsch Hans, Arolt Volker, Pfleiderer Bettina
Department of Clinical Radiology, University of Münster, Münster, Germany.
J ECT. 2006 Sep;22(3):189-95. doi: 10.1097/01.yct.0000235512.75568.43.
Depression is accompanied by disturbed implicit (unconscious) and explicit (conscious) memory functions. The aim was the assessment of immediate and delayed verbal and visual memory functions, concentration/attention during the course of electroconvulsive therapy (ECT) treatment.
Twenty severely depressed, drug-treatment resistant, elderly patients were assessed with the Wechsler Memory Scale-Revised (WMS-R) before and at the end of the ECT series.
Patients revealed deficits in acquisition (immediate verbal and visual memory), attention/concentration, and retrieval of information (delayed memory) before ECT. After ECT, significant improvements were observed in immediate memory but not in delayed memory. Although higher total stimulation levels (millicoulombs) (P = 0.015) were associated with improvements in immediate visual memory, we found that longer duration of convulsions (P = 0.016) as well as lower levels of stimulation at last ECT (P = 0.036) were associated with improvements in immediate verbal memory. Moreover, we found that stimulation energy (millicoulombs) in total and at last ECT was the best predictor among several clinical and ECT parameters of improved visual memory and concentration and decreased verbal and general memory.
Prefrontal cortex-related memory processes, especially immediate memory encoding, improved after ECT, whereas long-term memory remained impaired, indicating that severely depressed patients remain cognitively inferior to normal subjects despite clinically successful treatment. This study may yield a better understanding of the time course of memory alterations in severely depressed patients receiving ECT. Improvement of immediate memory may be essential for establishing normal daily activities of life in the recovery phase of depression.
抑郁症伴有内隐（无意识）和外显（有意识）记忆功能障碍。本研究旨在评估电休克治疗（ECT）过程中即刻和延迟的言语及视觉记忆功能、注意力/专注力。
20例重度抑郁、对药物治疗耐药的老年患者在ECT治疗系列开始前及结束时接受韦氏记忆量表修订版（WMS-R）评估。
患者在ECT治疗前表现出信息获取（即刻言语和视觉记忆）、注意力/专注力及信息提取（延迟记忆）方面的缺陷。ECT治疗后，即刻记忆有显著改善，但延迟记忆无改善。虽然较高的总刺激量（毫库仑）（P = 0.015）与即刻视觉记忆改善相关，但我们发现抽搐持续时间更长（P = 0.016）以及最后一次ECT时较低的刺激水平（P = 0.036）与即刻言语记忆改善相关。此外，我们发现总的及最后一次ECT时的刺激能量（毫库仑）是改善视觉记忆和专注力以及降低言语和总体记忆的多个临床及ECT参数中最佳的预测指标。
ECT治疗后，与前额叶皮质相关的记忆过程，尤其是即刻记忆编码有所改善，而长期记忆仍受损，这表明尽管临床治疗成功，但重度抑郁患者在认知上仍逊于正常受试者。本研究可能有助于更好地理解接受ECT治疗的重度抑郁患者记忆改变的时间进程。即刻记忆的改善对于抑郁症康复期建立正常的日常生活活动可能至关重要。
