The effects of electroconvulsive therapy on memory of autobiographical and public events
The effects of electroconvulsive therapy on memory of autobiographical and public events
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DOI：
10.1001/archpsyc.57.6.581
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发表时间：
2000-06-01
影响因子：
--
通讯作者：
Sackeim, HA
中科院分区：
文献类型：
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作者：
Lisanby, SH;Maddox, JH;Sackeim, HA
背景：逆行性遗忘症是电休克治疗(ECT)最持久的认知不良反应，但ECT对自体记忆和非个人记忆是否有不同的影响尚不清楚。本研究探讨了不同形式的ECT对个人和非个人(公共)事件记忆的短期和长期影响。方法：55例重度抑郁症患者被随机分配到右侧(RUL)或双侧(BL)ECT，每组分别接受低或高剂量的电刺激。个人和非个人记忆测试由盲评分者在基线、ECT后一周和2个月随访时进行。结果：ECT后不久，患者回忆的事件和事件细节比对照组少，与个人事件相比，最明显的缺陷是客观的。与RUL ECT相比，双侧ECT对事件和细节的遗忘更明显，尤其是对非个人记忆。这些效应与电剂量和临床结果无关。在2个月的随访中，患者的逆行健忘症有所减少，但在回忆客观事件的发生和最近非个人事件的细节方面仍然存在缺陷。结论：与自我知识(个人记忆)相比，ECT对关于世界的知识(非个人记忆)的遗忘效果最大，对最近事件的遗忘效果比对明显遥远事件的遗忘效果更强，对不显著事件的遗忘效果更持久。双侧ECT比RUL ECT产生更深刻的遗忘效应，特别是对客观事件的记忆。
Background: Retrograde amnesia is the most persistent cognitive adverse effect of electroconvulsive therapy (ECT); however, it is not known whether ECT has differential effects on autobiographical vs impersonal memories. This study examined the short- and long-term effects of differing forms of ECT on memory of personal and impersonal (public) events.Methods: Fifty-five patients with major depression were randomly assigned to right unilateral (RUL) or bilateral (BL) ECT, each at either low or high electrical dosage. The Personal and Impersonal Memory Test was administered by blinded raters at baseline, during the week after ECT, and at the 2-month follow-up. Normal controls were tested at matched intervals.Results: Shortly after ECT, patients recalled fewer events and event details than controls, with the deficits most marked for impersonal compared with personal events. Bilateral ECT caused more marked amnesia for events and details than RUL ECT, and especially for impersonal memories. These effects were independent of electrical dosage and clinical outcome. At the 2-month followup, patients had reduced retrograde amnesia, but continued to show deficits in recalling the occurrence of impersonal events and the details of recent impersonal events.Conclusions: The amnestic effects of ECT are greatest and most persistent for knowledge about the world (impersonal memory) compared with knowledge about the self (personal memory), for recent compared with distinctly remote events, and for less salient events. Bilateral ECT produces more profound amnestic effects than RUL ECT, particularly for memory of impersonal events.