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Objective cognitive performance associated with electroconvulsive therapy for depression: a systematic review and meta-analysis.

Abstract：

BACKGROUND:Electroconvulsive therapy (ECT) is the most acutely effective treatment for depression, but is limited by cognitive side effects. However, research on their persistence, severity, and pattern is inconsistent. We aimed to quantify ECT-associated cognitive changes, specify their pattern, and determine progression. METHODS:MEDLINE, EMBASE, PsycArticles, PsychINFO, PsychLIT, and reference lists were systematically searched through January 2009. We included all independent, within-subjects design studies of depressed patients receiving ECT where cognition was assessed using standardized tests. Main outcome was change in performance after ECT relative to pretreatment scores with respect to delay between finishing ECT and cognitive testing. We explored potential moderators' influence, e.g., electrode placement, stimulus waveform. RESULTS:Twenty-four cognitive variables (84 studies, 2981 patients) were meta-analyzed. No standardized retrograde amnesia tests were identified. Significant decreases in cognitive performance were observed 0 to 3 days after ECT in 72% of variables: effect sizes (ES) ranging from -1.10 (95% confidence interval [CI], -1.53 to -.67) to -.21 (95% CI, -.40 to .01). Four to 15 days post-ECT, all but one CI included zero or showed positive ES. No negative ES were observed after 15 days, with 57% of variables showing positive ES, ranging from .35 (95% CI, .07-.63) to .75 (95% CI, .43-1.08). Moderators did not influence cognitive outcomes after 3 days post-ECT. CONCLUSIONS:Cognitive abnormalities associated with ECT are mainly limited to the first 3 days posttreatment. Pretreatment functioning levels are subsequently recovered. After 15 days, processing speed, working memory, anterograde memory, and some aspects of executive function improve beyond baseline levels.

journal_name

Biol Psychiatry

journal_title

Biological psychiatry

authors

Semkovska M,McLoughlin DM

doi

10.1016/j.biopsych.2010.06.009

subject

Has Abstract

pub_date

2010-09-15 00:00:00

pages

568-77

issue

6

eissn

0006-3223

issn

1873-2402

pii

S0006-3223(10)00598-6

journal_volume

68

pub_type

杂志文章,meta分析,评审

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