Background: Electroconvulsive therapy (ECT) is the most effective treatment in a variety of psychiatric syndromes (especially mood disorders). However, one of its adverse effects is neurocognitive dysfunction. Declarative memory impairment after ECT is unquestionable and well investigated. There are only few ambiguous studies focused on nondeclarative or working memory changes during ECT. OBJECTIVES: The main objective of the presented study was to investigate working memory changes after ECT in comparison to pharmacological treatments. METHOD AND CHARACTERISTING OF THE STUDY GROUPS: Working memory functioning was assessed in 32 unmedicated patients with major depressive disorder (DSM-IV) who were then administered bilateral electroconvulsive therapy (ECT). Two additional groups were organized for comparision: first treated with Tricyclic antidepressants (TCAs ; imipramine or desipramine 150-250 mg/day; n=29) and second treated with newest antidepressants (venlafaxin; mirtazapine; reboxetine, n=30). Hamilton Depression Rating Scale (HDRS) and Beck's Depression Inventory (BDI) were used to assess the efficacy of antidepressant therapy. Cognitive functions were assessed with neuropsychological tests: Stroop A and B, TMT (Trial Making) A and B. The patients' status was evaluated 1 day before the treatment and 1 day, 2 weeks, 1 month and 6 months after the first ECT procedure. RESU ; LTS: All patients improved to a clinically significant degree. In ECT group 1 day after first treatment, patients’ working memory was slightly impaired, this result was statistically significant. All groups showed statistically significant improvement in working memory I month after start of treatment. However there were statistically significant differences between ECT and pharmacologically treated groups at the first month of therapy-there was greater improvement in both non-ECT groups than in ECT group. CONCLUSION: ECT treatment only temporally affects working memory function. The improvement of function may be a result of clinical recovery from depressive symphtomatology. There are several subpopulations of patients who have greater risk of developing cognitive disjunction after ECT . Therefore cognitive rehabilitation program should be implemented in standard ECT treatment because can slighty decrease cognitive dysfunction after ECT.
Uniwersytet Jagielloński – Collegium Medicum
Mar 10, 2023
Nov 21, 2012
|ZB-110716||Mar 10, 2023|
Jankowska, Agnieszka Wioleta