Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.
J ECT. 2011 Dec;27(4):286-91. doi: 10.1097/YCT.0b013e31821d3ab3.
Although electroconvulsive therapy (ECT) is a highly effective treatment for people with severe depression, many patients report that treatment-induced memory problems are the most disturbing and serious adverse effects, affecting quality of life after treatment and willingness to consent to further ECT sessions. To date, no intervention to mitigate these cognitive deficits has been developed. We introduce the methodology of a novel cognitive training program called Memory Training for ECT (Mem-ECT) that is based on cognitive training in seizure disorders. Mem-ECT is designed to help memories that are usually compromised after ECT to remain relatively preserved.
We evaluated the feasibility of implementing Mem-ECT in 8 adult patients with a diagnosis of major depressive disorder who underwent right unilateral ECT. This open pilot trial assessed recruitment procedures and treatment feasibility such as patient's burden and compliance, exercise length, and how best to integrate treatment sessions around the patient's schedule before undergoing ECT.
We found Mem-ECT to be fairly well tolerated by depressed inpatients and easily implemented within ECT treatment services.
We discuss issues for future development, including an ongoing treatment-masked controlled study we are conducting to test the efficacy of Mem-ECT. Developing a safe and effective behavioral strategy to minimize ECT's adverse effects on memory may make ECT a more easily tolerated treatment.
电痉挛疗法（ECT）虽然是治疗重度抑郁症患者的一种非常有效的方法，但许多患者报告称，治疗引起的记忆问题是最令人困扰和严重的不良反应，影响治疗后的生活质量和同意进一步接受 ECT 治疗的意愿。迄今为止，尚无干预措施来减轻这些认知缺陷。我们介绍了一种名为 ECT 记忆训练（Mem-ECT）的新型认知训练计划的方法，该计划基于癫痫症的认知训练。Mem-ECT 的设计目的是帮助在 ECT 后通常受损的记忆相对保持完整。
我们评估了在 8 名被诊断为重度抑郁症的成年患者中实施 Mem-ECT 的可行性，这些患者接受了右侧单侧 ECT。这项开放的初步试验评估了招募程序和治疗的可行性，例如患者的负担和依从性、运动时长，以及在接受 ECT 治疗前如何最好地根据患者的日程安排整合治疗。
我们发现，住院抑郁症患者能够较好地耐受 Mem-ECT，并且可以轻松地将其融入 ECT 治疗服务中。
我们讨论了未来发展的问题，包括我们正在进行的一项治疗掩蔽对照研究，以测试 Mem-ECT 的疗效。开发一种安全有效的行为策略来最小化 ECT 对记忆的不良影响，可能会使 ECT 成为一种更易耐受的治疗方法。
