Rummel Lea, Göke Katharina, Philipsen Alexandra, Hurlemann René, Kiebs Maximilian
Department of Psychiatry and Psychotherapy, School of Medicine & Health Sciences, University Hospital Oldenburg, Oldenburg, Germany.
Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
Front Psychiatry. 2024 Sep 26;15:1443270. doi: 10.3389/fpsyt.2024.1443270. eCollection 2024.
Electroconvulsive therapy (ECT) is the most effective treatment for patients suffering from treatment-resistant depression but its use is often limited by the concern for cognitive side effects. This study examines the effect of ECT on autobiographical and verbal memory compared to a healthy control group and the impact of the mean stimulus dose on cognition after ECT.
Autobiographical and verbal memory were assessed in depressed patients and healthy controls before the first and within one week after the last ECT treatment. Neuropsychological testing included the Autobiographical Memory Interview, the Verbal Learning and Memory Test and five tests from the Cambridge Neuropsychological Test Automated Battery. The mean charge delivered across the ECT series and the total number of sessions were examined in relationship to cognitive impairment after ECT using a multiple regression model.
Autobiographical memory was significantly impaired after ECT treatment compared to healthy controls. Baseline scores were lower for depressed patients on all cognitive domains. Improvements in performance after ECT were found on tests for executive functions and working memory. Effects of the mean charge delivered on cognitive functioning after ECT were heterogeneous across cognitive domains but significant for verbal retrograde memory.
ECT led to autobiographical memory impairment. The relationship between mean charge delivered and cognitive performance is heterogeneous across different cognitive domains and requires further research. Significant effects of the mean charge delivered were found without a significant difference in cognitive functioning compared to a healthy control group.
电休克疗法（ECT）是治疗难治性抑郁症患者最有效的方法，但其应用常常因对认知副作用的担忧而受到限制。本研究将ECT与健康对照组进行比较，考察其对自传体记忆和言语记忆的影响，以及平均刺激剂量对ECT后认知功能的影响。
在首次ECT治疗前及最后一次ECT治疗后一周内，对抑郁症患者和健康对照组进行自传体记忆和言语记忆评估。神经心理学测试包括自传体记忆访谈、言语学习和记忆测试以及剑桥神经心理学测试自动成套测验中的五项测试。使用多元回归模型，考察ECT系列治疗中传递的平均电量和治疗总次数与ECT后认知障碍之间的关系。
与健康对照组相比，ECT治疗后自传体记忆明显受损。抑郁症患者在所有认知领域的基线分数较低。ECT治疗后，执行功能和工作记忆测试的表现有所改善。ECT后传递的平均电量对认知功能的影响在不同认知领域存在差异，但对言语逆行性记忆有显著影响。
ECT导致自传体记忆受损。传递的平均电量与认知表现之间的关系在不同认知领域存在差异，需要进一步研究。在与健康对照组相比认知功能无显著差异的情况下，发现了传递的平均电量的显著影响。
