抑郁症电抽搐治疗的认知功能研究

Study on the cognition of depression disorder before and after ECT

目的 评定电抽搐治疗对抑郁患者认知功能的影响程度及影响因素。为临床电抽搐治疗减轻认知损害副反应 ,提高疗效提供理论依据。方法 5 5名符合CCMD 3抑郁发作患者进行了 6次电抽搐单一治疗方式 ,电抽搐采用硫苯妥钠诱导麻醉下 ,右侧电极直流巨形波的有抽搐治疗 ,于治疗前后分别测验临床记忆量及反应时。结果 电抽搐治疗前后临床记忆量表及反应时测定经配对t检验 ,指向记忆商 (分别为 15 .81± 7.5 8,13 .5 6± 5 .97,P <0 .0 1)及人象特点回忆商 (分别为 13 .78± 8.78,11.41± 6.69)治疗后均低于治疗前 ,联想学习商 (分别为 17.3 8± 7.96,19.5 6± 6.17,P <0 .0 1)分值较治疗前增高。治疗后反应时显著缩短 (分别为860 .16± 2 5 6.63 ,679.97± 176.0 0 ,P <0 .0 1)记忆商的减分值与硫苯妥钠使用总量、抽搐发作总时间、HAMD减分、诱发抽搐最低电压及年龄、性别无显著相关性。结论 电抽搐治疗后 ,抑郁患者指向记忆和人象特点回忆的负相作用及联想学习的正相作用受电抽搐治疗和抑郁状态下认知的双重影响。

Objective To estimate the degree and factors of ECT on cognition of patients with depression. Method Patients met CCMD-3 criteria for major depression were treated with a right unilateral, brief pulse, square-wave stimulus, dose titration ECT. Before and after a course of 6 times ECT Clinical Memory Score and Reaction Time were tested. The data of base voltage, seizure duration and demography was recorded. Results After ECT the reaction time and the subtests of target memory and image characteristic recall of Clinical Memory Scale Scores were lower than those of before ECT, while after ECT the subtest of association learning higher than that of before ECT. There were no relation between the change of Clinical Memory Scale Scores and convulsive duration minimum voltage sex and age.Conclusion The result tested by Clinical Memory Score and Reaction Time showed ECT has negative effect on the cognition of memory and recall , but it has a positive effect on learning.