Andrade Chittaranjan, Prasad Yameni, Devaraj Aathira, Pinto Ekta Franscina, Shukla Lekhansh
From the Departments of Psychopharmacology, and.
Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
J ECT. 2018 Jun;34(2):75-77. doi: 10.1097/YCT.0000000000000481.
Electroconvulsive therapy (ECT) is associated with memory deficits on neuropsychological assessment. The association of ECT with nonmemory cognitive deficits has been poorly studied.
We present a 40-year-old woman who showed a bizarre form of spatial cognition impairment on a subtest of the Tactual Performance Test (TPT) after recovering from depression with 6 alternate day, thrice-weekly, inpatient ECT treatments. This woman was part of a naturalistic, nonblind study that examined nonmemory cognitive deficits in antidepressant-treated depressed patients who did and did not receive ECT.
The impairment was in the form of bizarrely drawn reproductions of differently shaped wooden blocks that had been presented to the patient when she was blindfolded. The impairment was still evident when she was retested (3 hours later) under substantially simplified conditions but was much attenuated approximately 2.5 weeks later.
On the surface, it seems that ECT had induced severe impairment in spatial cognition and that the impairment showed the familiar pattern of attenuation with the passage of time. However, another recovered patient in the study, who did not receive ECT, also showed substantial spatial deficits on the same subtest of the TPT, and the attenuation of the deficits across time in the ECT-treated patient was probably a result of repeated exposure to the task. We suggest that not all patients who seem to experience spectacular cognitive impairment after ECT have deficits that are attributable to ECT.
电休克疗法（ECT）与神经心理学评估中的记忆缺陷有关。ECT与非记忆性认知缺陷之间的关联研究较少。
我们报告一名40岁女性，她在接受6次隔日、每周3次的住院ECT治疗后从抑郁症中康复，但在触觉操作测验（TPT）的一个子测试中表现出一种奇特的空间认知障碍形式。该女性是一项自然主义、非盲法研究的一部分，该研究调查了接受抗抑郁治疗的抑郁症患者（接受和未接受ECT）的非记忆性认知缺陷。
这种障碍表现为在患者蒙眼时呈现给她的不同形状木块的奇特绘制复制品。在大幅简化的条件下对她进行重新测试（3小时后）时，这种障碍仍然明显，但在大约2.5周后明显减轻。
表面上看，似乎ECT导致了严重的空间认知障碍，且这种障碍呈现出随着时间推移而减轻的常见模式。然而，该研究中的另一名康复患者未接受ECT，在TPT的同一子测试中也表现出明显的空间缺陷，ECT治疗患者的缺陷随时间的减轻可能是由于反复接触该任务所致。我们认为，并非所有在ECT后似乎出现明显认知障碍的患者都存在可归因于ECT的缺陷。
