Laboratorio de Epidemiología Clínica, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico.
Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Université du Québec à Montréal, Canada.
J Affect Disord. 2022 Nov 1;316:148-160. doi: 10.1016/j.jad.2022.08.005. Epub 2022 Aug 8.
Electroconvulsive therapy (ECT) is an effective treatment for depression, mania, and refractory schizophrenia. Its tolerability profile is established for acute treatment, but less is known regarding the effects of longer treatment courses, particularly on cognitive performance.
To assess the effect of the long-term ECT on cognition.
We searched CINAHL, EMBASE, PsychInfo and Pubmed, for the period between January 1, 2010, and June 30, 2022, in English or French, for randomized controlled trials, prospective or retrospective studies of ECT continued for at least 2 months for the treatment of mood or schizophrenic disorders and which measured cognition before and at the end of treatment. Non-peer reviewed records were excluded. The Cochrane Risk of Bias tool was used to assess study quality. Classical meta-analyses, with heterogeneity statistics (tau, I) were complemented with three level-meta-analysis and Bayesian Meta-analyses.
Nine studies were included in the narrative and quantitative review. Controlled comparison at 6 months (k = 6, n = 334) and at 12 months (k = 3, n = 56), within-subject comparisons at 6 (k = 6, n = 218) and 12 months (k = 4, n = 147) showed no detrimental effect of maintenance or continuation ECT on cognition, with little to no heterogeneity. Bayesian analysis further confirmed that data better supported the no effects hypothesis.
Insufficient data resulted in imprecision in estimates.
Continuation and maintenance ECT do not appear detrimental for cognitive performance. However, the low number of studies limit the interpretation of the results.
电抽搐治疗（ECT）是治疗抑郁症、躁狂症和难治性精神分裂症的有效方法。其急性治疗的耐受性已得到证实，但对于更长时间的治疗过程（尤其是对认知表现的影响）了解较少。
评估长期 ECT 对认知的影响。
我们在 CINAHL、EMBASE、PsychInfo 和 Pubmed 上进行了检索，检索时间为 2010 年 1 月 1 日至 2022 年 6 月 30 日，检索语言为英语或法语，纳入了针对心境障碍或精神分裂症患者进行至少 2 个月 ECT 治疗的随机对照试验、前瞻性或回顾性研究，这些研究测量了治疗前后的认知功能。排除非同行评议的记录。使用 Cochrane 偏倚风险工具评估研究质量。采用经典的荟萃分析（包括异质性统计量[tau，I]），并辅以三级荟萃分析和贝叶斯荟萃分析。
纳入了 9 项研究进行叙述性和定量综述。6 个月时（k=6，n=334）和 12 个月时（k=3，n=56）的对照研究、6 个月（k=6，n=218）和 12 个月（k=4，n=147）时的自身对照研究均显示，维持或继续 ECT 对认知功能没有不良影响，异质性较小。贝叶斯分析进一步证实，数据更支持无影响假设。
数据不足导致估计值不精确。
继续进行 ECT 治疗似乎不会对认知表现造成损害。然而，研究数量较少限制了结果的解释。
