Ziegelmayer Christoph, Hajak Göran, Bauer Anne, Held Marion, Rupprecht Rainer, Trapp Wolfgang
From the *Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Social Foundation Bamberg, Bamberg; †Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg; and ‡Department of Physiological Psychology, Otto-Friedrich University Bamberg, Bamberg, Germany.
J ECT. 2017 Jun;33(2):104-110. doi: 10.1097/YCT.0000000000000385.
Although electroconvulsive therapy (ECT) is considered a safe and highly effective treatment option for major depressive disorder, there are still some reservations with regard to possible adverse cognitive adverse effects. This is the case despite a large body of evidence showing that these deficits are transient and that there even seems to be a long-term improvement of cognitive functioning level. However, most data concerning cognitive adverse effects stem from studies using mixed samples of treatment-resistant and non-treatment-resistant as well as ECT-naive and non-ECT-naive subjects. Furthermore, neurocognitive measures might partly be sensitive to practice effects and improvements in depressive symptom level.
We examined neurocognitive performance in a sample of 20 treatment-resistant and ECT-naive subjects using repeatable neurocognitive tests, whereas changes in depressive symptom level were controlled. Cognitive functioning level was assessed before (baseline), 1 week, and 6 months (follow-up 1 and 2) after (12 to) 15 sessions of unilateral ECT treatment.
No adverse cognitive effects were observed in any of the cognitive domains examined. Instead, a significant improvement in verbal working memory performance was found from baseline to follow-up 2. When changes in depressive symptom levels were controlled statistically, this improvement was no longer seen.
Although findings that ECT does not lead to longer lasting cognitive deficits caused by ECT were confirmed, our study adds evidence that previous results of a beneficial effect of ECT on cognition might be questioned.
尽管电休克治疗（ECT）被认为是治疗重度抑郁症的一种安全且高效的治疗选择，但对于其可能产生的不良认知副作用仍存在一些疑虑。尽管有大量证据表明这些缺陷是短暂的，甚至认知功能水平似乎会有长期改善，但情况依然如此。然而，大多数关于认知副作用的数据来自使用难治性和非难治性以及初治和非初治ECT受试者的混合样本的研究。此外，神经认知测量可能部分对练习效应和抑郁症状水平的改善敏感。
我们使用可重复的神经认知测试，对20名难治性且未接受过ECT治疗的受试者样本进行神经认知表现检查，同时控制抑郁症状水平的变化。在单侧ECT治疗（12至）15次之前（基线）、1周以及6个月（随访1和2）后评估认知功能水平。
在所检查的任何认知领域均未观察到不良认知影响。相反，从基线到随访2，言语工作记忆表现有显著改善。当对抑郁症状水平的变化进行统计学控制时，这种改善不再明显。
尽管ECT不会导致由ECT引起的持久认知缺陷这一发现得到了证实，但我们的研究补充了证据，表明ECT对认知有益的先前结果可能受到质疑。
