Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands; Amsterdam Brain and Cognition, Amsterdam, The Netherlands.
Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands.
Brain Stimul. 2017 Sep-Oct;10(5):959-966. doi: 10.1016/j.brs.2017.07.006. Epub 2017 Jul 19.
Electroconvulsive Therapy (ECT) and Deep Brain Stimulation (DBS) are effective treatments for patients with treatment-resistant depression (TRD). However, a common side effect of ECT is autobiographical memory loss (e.g., personal experiences), whereas the impact of DBS on autobiographical memories has never been established.
Comparing autobiographical memories following DBS and ECT.
In two hospitals in The Netherlands, we interviewed 25 TRD patients treated with DBS of the ventral anterior limb of the internal capsule (vALIC), 14 TRD patients treated with ECT and 22 healthy controls (HC) with the Autobiographical Memory Inventory - Short Form (AMI-SF) in a prospective, longitudinal study between March 2010 and August 2016. Patients treated with DBS were interviewed before surgery, after surgery, and twice during treatment over 122.7 (SD: ±22.2) weeks. Patients treated with ECT were tested before ECT, after six right unilateral (RUL) ECT sessions and twice following ECT over 65.1 (±9.3) weeks. Controls were tested four times over 81.5 (±15.6) weeks.
Compared to HC, the AMI-SF score decreased faster in both TRD groups (P < 0.001). More specifically, AMI-SF score decreased in a comparable rate as HC after DBS surgery, but decreased more during treatment. The AMI-SF decrease in the ECT group was larger than both the DBS and HC groups.
Both ECT and vALIC DBS result in a faster autobiographical memory decline compared to HC. DBS might have a negative impact on autobiographical memories, although less so than ECT. Future work should dissect whether DBS or characteristics of TRD cause this decline.
电痉挛疗法（ECT）和深部脑刺激（DBS）是治疗难治性抑郁症（TRD）患者的有效方法。然而，ECT 的常见副作用是自传体记忆丧失（例如个人经历），而 DBS 对自传体记忆的影响尚未确定。
比较 DBS 和 ECT 后的自传体记忆。
在荷兰的两家医院，我们对 25 名接受腹侧前肢内囊（vALIC）DBS 治疗的 TRD 患者、14 名接受 ECT 治疗的 TRD 患者和 22 名健康对照者（HC）进行了前瞻性、纵向研究，采用自传体记忆量表 - 短式（AMI-SF）进行访谈。接受 DBS 治疗的患者在手术前、手术后和治疗期间共接受了 122.7（SD：±22.2）周的 2 次访谈。接受 ECT 治疗的患者在 ECT 前、6 次右侧单侧（RUL）ECT 治疗后和 ECT 后共接受了 2 次治疗，共进行了 65.1（±9.3）周的治疗。对照组在 81.5（±15.6）周内接受了 4 次测试。
与 HC 相比，TRD 组的 AMI-SF 评分下降速度更快（P<0.001）。更具体地说，DBS 手术后 AMI-SF 评分的下降速度与 HC 相似，但在治疗过程中下降更快。ECT 组的 AMI-SF 下降幅度大于 DBS 组和 HC 组。
与 HC 相比，ECT 和 vALIC DBS 都会导致自传体记忆下降更快。DBS 可能对自传体记忆产生负面影响，尽管不如 ECT 严重。未来的研究应剖析是 DBS 还是 TRD 的特征导致了这种下降。
