Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
Department of Psychology, University of Limerick, Limerick, Ireland.
Prim Care Companion CNS Disord. 2020 May 14;22(3):19m02547. doi: 10.4088/PCC.19m02547.
To examine the short- and long-term effect of electroconvulsive therapy on verbal, visual, and autobiographical memory functions in patients treated for a severe depressive episode. Patients were compared with healthy controls undergoing neurocognitive assessments at the same time points to account for normal forgetfulness and potential learning effects.
A pre-post intervention design included patients (n = 38) and controls (n = 16) referred to Haukeland University Hospital for electroconvulsive therapy (ECT) from September 2013 to September 2018. Patients diagnosed with a major depressive episode (according to ICD-10 criteria) underwent right unilateral ECT with brief-pulse, square-wave, constant current. Neurocognitive assessments were administered pretreatment and, on average, 19 days and 6 months posttreatment. Performance on the California Verbal Learning Test Second Edition, Rey Osterrich Complex Figure, and Autobiographical Memory Interview-Short Form were the main outcome measures, examining verbal, visual, and autobiographical memory, respectively.
Patients performed significantly worse compared to controls on all measures of verbal and visual memory at every assessment (P ≤ .001). Within-group analyses showed no impaired visual or verbal memory function due to ECT. However, autobiographical consistency was significantly decreased for patients (70.30%) compared to controls (82.03%) 6 months posttreatment (P = .0005).
Patients' ability to acquire new general knowledge is considered as unaffected by ECT. Deficits in autobiographic memory were found 6 months posttreatment, indicating both an iatrogenic effect of treatment and an effect of depression on retrograde memory functions. For patients, the risk of this iatrogenic effect of treatment must be evaluated against the symptomatic and potential functional recovery due to ECT.
Clinicaltrials.gov identifier: NCT04348825.
研究电抽搐治疗对治疗重度抑郁发作患者的言语、视觉和自传体记忆功能的短期和长期影响。为了说明正常遗忘和潜在的学习效果，将患者与同时进行神经认知评估的健康对照者进行比较。
采用前后干预设计，纳入 2013 年 9 月至 2018 年 9 月期间因电抽搐治疗（ECT）被转诊到豪克兰德大学医院的患者（n=38）和对照者（n=16）。诊断为重度抑郁发作（根据 ICD-10 标准）的患者接受右侧单侧 ECT，采用短脉冲、方波、恒流。在治疗前和平均 19 天和 6 个月后进行神经认知评估。主要的结果测量指标是加利福尼亚词语学习测试第二版、 Rey Osterrich 复杂图形和自传体记忆访谈-短式，分别评估言语、视觉和自传体记忆。
与对照组相比，患者在所有言语和视觉记忆评估中均表现出明显的较差表现（P≤0.001）。组内分析显示 ECT 并未导致视觉或言语记忆功能受损。然而，6 个月后患者的自传体一致性明显降低（70.30%）与对照组（82.03%）相比（P=0.0005）。
患者获取新知识的能力被认为不受 ECT 的影响。在治疗后 6 个月时发现自传体记忆缺陷，这表明治疗的医源性效应以及抑郁对逆行记忆功能的影响。对于患者，必须权衡 ECT 治疗的这种医源性效应与因 ECT 而产生的症状和潜在的功能恢复之间的风险。
Clinicaltrials.gov 标识符：NCT04348825。
