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预防性认知增强剂用于改善接受电休克治疗患者的认知功能:一项系统评价和荟萃分析。

Prophylactic cognitive enhancers for improvement of cognitive function in patients undergoing electroconvulsive therapy: A systematic review and meta-analysis.

作者信息

Niu Yunlian, Ye Dan, You Yijie, Wu Jian

机构信息

Department of Neurology, The First People's Hospital of Changzhou.

Department of Neurology, The Third Affiliated Hospital of Soochow University.

出版信息

Medicine (Baltimore). 2020 Mar;99(11):e19527. doi: 10.1097/MD.0000000000019527.


DOI:10.1097/MD.0000000000019527
PMID:32176105
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7440112/
Abstract

OBJECTIVE: Cognitive enhancers, including cholinesterase inhibitors and memantine, are used to treat dementia, but their effect for reducing post-electroconvulsive therapy (post-ECT) cognitive side effects is unclear. We conducted a systematic review and meta-analysis to assess the effectiveness of cognitive enhancers in the prevention of cognitive side effects due to ECT. METHODS: We identified relevant studies by searching electronic databases (e.g., PubMed, EMBASE, Web of Science, Cochrane Library). Only studies published up to October 2019 comparing cognitive enhancer vs placebo for cognitive function after ECT were included. The primary outcome extracted from the studies was cognitive function score. RESULTS: Five studies with 202 patients were included in this study. The cognitive enhancer group (CEG) had a significantly higher cognitive function score. Moreover, sensitivity analysis showed that no individual study had a significant impact on the overall results. CONCLUSIONS: This meta-analysis revealed that cognitive enhancers might improve cognitive function and reduce ECT-induced cognitive side effects. Nevertheless, more high-quality randomized controlled trials (RCTs) with long-term follow-up are still needed to make the final conclusion.

摘要

目的:认知增强剂,包括胆碱酯酶抑制剂和美金刚,被用于治疗痴呆症,但其对减轻电惊厥治疗(ECT)后认知副作用的效果尚不清楚。我们进行了一项系统评价和荟萃分析,以评估认知增强剂在预防ECT所致认知副作用方面的有效性。 方法:我们通过检索电子数据库(如PubMed、EMBASE、科学网、Cochrane图书馆)来识别相关研究。仅纳入截至2019年10月发表的比较认知增强剂与安慰剂对ECT后认知功能影响的研究。从这些研究中提取的主要结局是认知功能评分。 结果:本研究纳入了5项涉及202例患者的研究。认知增强剂组(CEG)的认知功能评分显著更高。此外,敏感性分析表明,没有任何一项单独研究对总体结果有显著影响。 结论:这项荟萃分析表明,认知增强剂可能改善认知功能并减少ECT引起的认知副作用。然而,仍需要更多长期随访的高质量随机对照试验(RCT)来得出最终结论。

相似文献

[1]
Prophylactic cognitive enhancers for improvement of cognitive function in patients undergoing electroconvulsive therapy: A systematic review and meta-analysis.

Medicine (Baltimore). 2020-3

[2]
Erythropoietin as an add-on treatment for cognitive side effects of electroconvulsive therapy: a study protocol for a randomized controlled trial.

Trials. 2018-4-19

[3]
Acetylcholinesterase inhibitors for electroconvulsive therapy-induced cognitive side effects: a systematic review.

Int J Geriatr Psychiatry. 2017-3-10

[4]
Long-term cognitive effects of electroconvulsive therapy in major depressive disorder: A systematic review and meta-analysis.

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[5]
Bitemporal v. high-dose right unilateral electroconvulsive therapy for depression: a systematic review and meta-analysis of randomized controlled trials.

Psychol Med. 2017-2

[6]
Pharmacological interventions to diminish cognitive side effects of electroconvulsive therapy: A systematic review and meta-analysis.

Acta Psychiatr Scand. 2022-4

[7]
Therapeutic and prophylactic utility of the memory-enhancing drug donepezil hydrochloride on cognition of patients undergoing electroconvulsive therapy: a randomized controlled trial.

J ECT. 2006-9

[8]
Memantine in the prevention or alleviation of electroconvulsive therapy induces cognitive disorders: A placebo controlled trial.

Asian J Psychiatr. 2015-6

[9]
Efficacy and safety of cognitive enhancers for patients with mild cognitive impairment: a systematic review and meta-analysis.

CMAJ. 2013-9-16

[10]
Effects of electroconvulsive therapy on cognitive functioning in patients with depression: protocol for a systematic review and meta-analysis.

BMJ Open. 2015-3-11

引用本文的文献

[1]
The Role of Acetylcholinesterase Inhibitors in the Treatment of Prolonged Postelectroconvulsive Therapy Delirium.

Case Rep Psychiatry. 2022-5-30

[2]
Cognition enhancing effect of rosemary (Rosmarinus officinalis L.) in lab animal studies: a systematic review and meta-analysis.

Braz J Med Biol Res. 2022

[3]
Pharmacological interventions to diminish cognitive side effects of electroconvulsive therapy: A systematic review and meta-analysis.

Acta Psychiatr Scand. 2022-4

[4]
Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions.

Front Psychol. 2021-11-23

本文引用的文献

[1]
MMSE Changes During and After ECT in Late-Life Depression: A Prospective Study.

Am J Geriatr Psychiatry. 2019-4-23

[2]
Effect of Donepezil on Cognitive Deficits Associated With Electroconvulsive Therapy: A Randomized Triple-blind Clinical Trial.

Clin Neuropharmacol. 2019

[3]
Adverse effects of electroconvulsive therapy on cognitive performance.

Ment Illn. 2017-10-19

[4]
Memantine for Alzheimer's Disease: An Updated Systematic Review and Meta-analysis.

J Alzheimers Dis. 2017

[5]
Acetylcholinesterase inhibitors for electroconvulsive therapy-induced cognitive side effects: a systematic review.

Int J Geriatr Psychiatry. 2017-3-10

[6]
Adverse Effects of Electroconvulsive Therapy.

Psychiatr Clin North Am. 2016-9

[7]
Cognitive Impairment and Electroconvulsive Therapy in Geriatric Depression, What Could be the Role of Rivastigmine? A Case Series.

Clin Pract. 2015-9-28

[8]
Effect of Memantine on Cognitive Performance in Patients Under Electroconvulsive Therapy: A Double-Blind Randomized Clinical Trial.

Clin Neuropharmacol. 2015

[9]
Memantine in the prevention or alleviation of electroconvulsive therapy induces cognitive disorders: A placebo controlled trial.

Asian J Psychiatr. 2015-6

[10]
Multifactorial determinants of the neurocognitive effects of electroconvulsive therapy.

J ECT. 2014-6

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