Hermida Adriana P, Goldstein Felicia C, Loring David W, McClintock Shawn M, Weiner Richard D, Reti Irving M, Janjua A Umair, Ye Zixun, Peng Limin, Tang Yi-Lang, Galendez Gail C, Husain Mustafa M, Maixner Daniel F, Riva-Posse Patricio, McDonald William M
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive, Atlanta, GA, USA.
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.
J Affect Disord. 2020 May 15;269:36-42. doi: 10.1016/j.jad.2020.03.010. Epub 2020 Mar 4.
Electroconvulsive therapy (ECT) is a well-established treatment for severe depression but may result in adverse cognitive effects. Available cognitive screening instruments are nonspecific to the cognitive deficits associated with ECT. An ECT-cognitive assessment tool which can be easily administered was developed and validated in a clinical setting.
One hundred and thirty-six participants were enrolled. The ElectroConvulsive therapy Cognitive Assessment (ECCA) and the Montreal Cognitive Assessment (MoCA) were administered prospectively to 55 participants with major depressive disorder (MDD) undergoing ECT at three time points: pre-treatment, before the sixth treatment and one-week post-treatment. The psychometric properties of the total and domain scores were evaluated at all three time points. Forty demographically comparable participants with MDD who did not receive ECT, and 41 healthy, age-matched controls were evaluated at a single time point.
ECCA and MoCA scores were not statistically different at baseline. Prior to the sixth and final ECT session, total ECCA scores were significantly lower than the MoCA total scores. The ECCA domains of subjective memory, informant-assessed memory, attention, autobiographical memory and delayed verbal recall were significantly lower post-ECT compared to pre-ECT.
The ECCA was compared only to the MoCA rather than to a more comprehensive neuropsychological testing. This limitation reflected the real-life clinical burden of performing full neuropsychological testing at three time points during the treatment course.
The ECCA is a brief, reliable, bedside cognitive screening assessment tool that may be useful to monitor cognitive function in patients treated with ECT. The test can be downloaded from fuquacenter.org/ecca.
电休克疗法（ECT）是治疗重度抑郁症的一种成熟疗法，但可能会导致不良认知效应。现有的认知筛查工具对与ECT相关的认知缺陷缺乏特异性。一种易于实施的ECT认知评估工具已在临床环境中开发并验证。
招募了136名参与者。对55名接受ECT治疗的重度抑郁症（MDD）患者在三个时间点进行前瞻性评估：治疗前、第六次治疗前和治疗后一周，使用电休克疗法认知评估（ECCA）和蒙特利尔认知评估（MoCA）。在所有三个时间点评估总分和各领域分数的心理测量特性。对40名未接受ECT的人口统计学特征相似的MDD患者和41名年龄匹配的健康对照者在单一时间点进行评估。
基线时ECCA和MoCA分数无统计学差异。在第六次也是最后一次ECT治疗前，ECCA总分显著低于MoCA总分。与ECT治疗前相比，ECT治疗后主观记忆、 informant评估的记忆、注意力、自传体记忆和延迟言语回忆等ECCA领域显著降低。
ECCA仅与MoCA进行了比较，而非与更全面的神经心理学测试进行比较。这一局限性反映了在治疗过程中的三个时间点进行全面神经心理学测试的实际临床负担。
ECCA是一种简短、可靠的床边认知筛查评估工具，可能有助于监测接受ECT治疗患者的认知功能。该测试可从fuquacenter.org/ecca下载。
