Memory, attention, and executive functions before and after sine and pulse wave electroconvulsive therapies for treatment-resistant major depression
Memory, attention, and executive functions before and after sine and pulse wave electroconvulsive therapies for treatment-resistant major depression
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DOI：
10.1097/00124509-200606000-00006
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发表时间：
2006-06-01
期刊：
影响因子：
2.5
通讯作者：
Furukawa, Toshi A.
中科院分区：
文献类型：
--
作者：
Fujita, Akiko;Nakaaki, Shutaro;Furukawa, Toshi A.
到目前为止，对电休克治疗(ECT)的认知效应的研究一直存在争议，部分原因是研究人员和评价者并不总是对认知的各个方面进行明确的区分，而且ECT的管理中涉及许多参数，这些参数对认知有潜在的影响。本研究旨在探讨正弦波和脉搏波对顺行记忆和非认知功能的影响。方法：18例单相重度抑郁症或双相I或II障碍患者，最近一次发作为抑郁症，接受正弦波或脉搏波ECT，并在ECT前后用神经心理学测试组合测量顺行记忆、注意力和执行功能。在最后一次ECT治疗后平均8.2天测量结果。结果：两种波形在缓解抑郁方面同样有效。接受正弦波电刺激的受试者在注意力和执行任务方面表现出显著的恶化，如测量选择性注意力的Stroop测验(P=0.02)和利用分散注意力的双重任务(P=0.01)。而接受脉搏波电刺激的患者在视觉记忆(P=0.01)、韦氏记忆量表(WMS-R)的一般记忆(P=0.01)以及双重任务(P=0.01)等记忆任务中均有明显改善。组间比较显示脉搏波优于正弦波(P=0.004)。结论：无论波形如何，电刺激后1周，顺行记忆均较治疗前有显著或无统计学意义的改善。注意/执行功能随正弦波电刺激而恶化，而随脉搏波刺激而改善。
Studies of the cognitive effects of electroconvulsive therapy (ECT) have resulted in controversial findings up to now, partly because researchers and reviewers have not always made a clear distinction among various aspects of cognition and because there are many parameters involved in the administration of ECT that have a potential impact on cognition. The present study focused on the impact of sine and pulse waveforms on anterograde memory and nonmemory cognitive functions.Methods: We assigned 18 patients with unipolar major depression or bipolar I or II disorder, most recent episode depressed, to receive sine wave or pulse wave ECT and assessed their cognitive function before and after ECT, using a neuropsychologic test battery that measured anterograde memory, attention, and executive functions. Outcomes were measured, on average, 8.2 days after the last ECT session.Results: Both waveforms were equally effective in alleviating depression. Those who received sine wave ECT showed statistically significant deterioration in attention and executive tasks, such as the Stroop test, which measures selective attention (P = 0.02), and the dual task, which taps divided attention (P = 0.01). On the other hand, those who received pulse wave ECT improved to a significant degree in certain memory tasks, such as visual memory (P = 0.01) and general memory (P = 0.01) of the Wechsler Memory Scale-Revised (WMS-R), as well as in the dual task (P = 0.01). The between-group comparison revealed robust superiority of the pulse wave over the sine wave in terms of the dual task (P = 0.004).Conclusions: Anterograde memory improved to a statistically significant or nonsignificant degree at 1 week post-ECT in comparison with pre-ECT regardless of waveforms. Attention/executive functions tended to deteriorate with sine wave ECT but improved with pulse wave ECT.