Kalogerakou Stamatina, Oulis Panagiotis, Anyfandi Eleni, Konstantakopoulos George, Papakosta Vasiliki-Maria, Kontis Dimitrios, Theochari Eirini, Angelopoulos Elias, Zervas Ioannis M, Mellon Robert C, Papageorgiou Charalambos C, Tsaltas Eleftheria
From the *Experimental Psychology Laboratory, 1st Department of Psychiatry, Eginition Hospital, Athens University Medical School, Athens, Greece; †Laboratory of Experimental and Applied Behavior Analysis, Department of Psychology, Panteion University of Social and Political Sciences; ‡1st Department of Psychiatry, Eginition Hospital, Athens University Medical School; Athens, Greece §Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK; ∥Unit for the Study of Cognition in Psychosis, Psychiatric Hospital of Attica, Athens, Greece.
J ECT. 2015 Dec;31(4):246-52. doi: 10.1097/YCT.0000000000000238.
This study is a follow-up of a previous one reporting that the neuropsychological profile of pharmacoresistant patients with major depressive disorder referred for electroconvulsive therapy (ECT, ECT group) contrasted with that of their pharmacorespondent counterparts (NECT group). The NECT group exhibited severe visuospatial memory and minor executive deficits; the ECT group presented the reverse pattern. In that same ECT group, the current follow-up study examined the effects of clinically effective ECT on both cognitive domains 2 months later.
Fifteen ECT patients were administered Hamilton Depression (HAMD-24), Hamilton Anxiety (HAMA), Mini-Mental State Examination Scales and 5 tests of Cambridge Neuropsychological Test Automated Battery at intake (pre-ECT), end of ECT course (post-ECT), and 2 months thereafter (follow-up).
Electroconvulsive therapy was effective in relieving clinical depression. After a post-ECT decline, the patients exhibited significant improvement in both Cambridge Neuropsychological Test Automated Battery, paired associate learning, and Stockings of Cambridge. By contrast, their major pre-ECT deficit in intra/extradimensional set shifting remained virtually unaffected.
Our findings suggest that attentional flexibility deficits may constitute a neuropsychological trait-like feature of pharmacoresistant, ECT-referred major depressive disorder patients. However, this deficit does not seem generalized, given patient improvement in episodic visual learning/memory and some indication of improvement in spatial planning after ECT.
本研究是对先前一项研究的随访，先前研究报告称，被转诊接受电休克治疗（ECT，ECT组）的重度抑郁症药物抵抗患者的神经心理学特征与其药物反应性对应患者（NECT组）形成对比。NECT组表现出严重的视觉空间记忆和轻微的执行功能缺陷；ECT组则呈现相反的模式。在同一ECT组中，当前的随访研究在2个月后考察了临床有效的ECT对这两个认知领域的影响。
15名ECT患者在入院时（ECT前）、ECT疗程结束时（ECT后）以及此后2个月（随访）接受汉密尔顿抑郁量表（HAMD - 24）、汉密尔顿焦虑量表（HAMA）、简易精神状态检查表以及剑桥神经心理测试自动成套测验的5项测试。
电休克治疗在缓解临床抑郁方面有效。在ECT后出现下降之后，患者在剑桥神经心理测试自动成套测验、配对联想学习和剑桥长袜测验方面均有显著改善。相比之下，他们在ECT前主要的维度内/维度间转换缺陷几乎未受影响。
我们的研究结果表明，注意力灵活性缺陷可能是药物抵抗的、被转诊接受ECT的重度抑郁症患者的一种神经心理学特质样特征。然而，鉴于患者在情景视觉学习/记忆方面有所改善以及ECT后空间规划有改善的迹象，这种缺陷似乎并不普遍。
