Polster Julia D, Kayser Sarah, Bewernick Bettina H, Hurlemann René, Schlaepfer Thomas E
From the *Department of Psychiatry and Psychotherapy, University Hospital, Bonn, Germany and †Departments of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD.
J ECT. 2015 Mar;31(1):13-9. doi: 10.1097/YCT.0000000000000130.
Electroconvulsive therapy (ECT) is currently the most effective treatment for severe depression. However, it is frequently associated with negative cognitive side effects. Magnetic seizure therapy (MST) depicts an alternative, although experimental, convulsive treatment for major depression. Initial results suggest comparable antidepressant effects accompanied by a better side effect profile. However, no studies up to now have addressed acute retrieval disruption after MST in comparison to ECT. Therefore, we intended to broaden insight into the side effect profile of MST compared to ECT by examining the disruption of acute verbal memory processes after treatment.
Twenty depressed patients were randomly assigned to either MST (10 patients) or ECT (10 patients) treatment. On 2 treatment days and 2 treatment-free days, the patients memorized words using a controlled learning paradigm derived from the Batchelder and Riefer storage retrieval model. Four hours after memorization, the patients were asked to retrieve words freely (delayed recall) and a second time with the help of an additional cue constructed out of a hypernymic category (cued recall). By comparing memory performance on treatment days to control days, treatment-induced memory disruption was evaluated.
After ECT, delayed recall was disturbed, whereas after MST, it was not. However, this difference in performance was no longer apparent upon cue application (cued recall).
This study demonstrates that ECT-induced acute memory disruption measured by delayed recall is absent after MST, confirming its superior side effect profile. We hope that confirming advantages of MST over ECT will improve therapy options for patients with severe depression.
电休克疗法(ECT)是目前治疗重度抑郁症最有效的方法。然而,它经常伴有负面的认知副作用。磁休克疗法(MST)是一种用于治疗重度抑郁症的替代方法,尽管仍处于实验阶段。初步结果表明,其抗抑郁效果相当,且副作用较小。然而,目前尚无研究比较MST和ECT治疗后对急性记忆恢复的影响。因此,我们旨在通过研究治疗后急性言语记忆过程的中断情况,深入了解MST与ECT相比的副作用特征。
20名抑郁症患者被随机分为MST组(10例)和ECT组(10例)。在2个治疗日和2个非治疗日,患者采用源自Batchelder和Riefer存储检索模型的受控学习范式记忆单词。记忆4小时后,要求患者自由回忆单词(延迟回忆),并借助由上位类别构建的额外线索再次回忆(线索回忆)。通过比较治疗日与对照日的记忆表现,评估治疗引起的记忆中断情况。
ECT治疗后延迟回忆受到干扰,而MST治疗后则未受干扰。然而,在应用线索(线索回忆)后,这种表现差异不再明显。
本研究表明,MST治疗后不存在ECT治疗后通过延迟回忆测得的急性记忆中断情况,证实了其更好的副作用特征。我们希望证实MST优于ECT的优势将改善重度抑郁症患者的治疗选择。