Abstract：
BACKGROUND: Major Depressive Disorder (MDD) affects 350 million people worldwide. Electroconvulsive therapy (ECT) is effective, yet research on cognitive assessments post-treatment is lacking. This study systematically reviews and meta-analyzes the effectiveness of cognitive assessment tools post-ECT to optimize MDD treatment.
METHODS: Following PRISMA guidelines, this review was pre-registered on PROSPERO (CRD42023470318). Searches were conducted across nine databases up to November 12, 2023. Quality assessment for Randomized Controlled Trials (RCTs) and quasi-experimental studies was performed using the Cochrane risk of bias tool, JBI critical appraisal tools, and the Jadad scale. Meta-analyses for short-term and long-term cognitive function involved 24 and 18 tools, respectively.
RESULTS: Thirty studies (20 RCTs and 10 quasi-experimental) involving 2462 MDD patients were evaluated. Results indicated no significant differences in overall short-term and long-term cognitive functions post-ECT. Short-term analysis showed impairments in memory, learning, and verbal abilities but improvements in attention and processing speed. Long-term analysis revealed enhancements in memory, learning, verbal, and visuospatial abilities compared to baseline. Based on GRADE classification, we recommend 11 tools for assessing acute cognitive function and 10 tools for chronic cognitive impairment. These tools demonstrated high reliability and validity, supporting their clinical use.
CONCLUSIONS: These findings provide critical evidence for future ECT clinical guidelines in managing MDD. The recommended tools can aid clinicians in adjusting ECT regimens, identifying early cognitive changes, and improving therapeutic outcomes in MDD treatment.
METHODS: Following PRISMA guidelines, this review was pre-registered on PROSPERO (CRD42023470318). Searches were conducted across nine databases up to November 12, 2023. Quality assessment for Randomized Controlled Trials (RCTs) and quasi-experimental studies was performed using the Cochrane risk of bias tool, JBI critical appraisal tools, and the Jadad scale. Meta-analyses for short-term and long-term cognitive function involved 24 and 18 tools, respectively.
RESULTS: Thirty studies (20 RCTs and 10 quasi-experimental) involving 2462 MDD patients were evaluated. Results indicated no significant differences in overall short-term and long-term cognitive functions post-ECT. Short-term analysis showed impairments in memory, learning, and verbal abilities but improvements in attention and processing speed. Long-term analysis revealed enhancements in memory, learning, verbal, and visuospatial abilities compared to baseline. Based on GRADE classification, we recommend 11 tools for assessing acute cognitive function and 10 tools for chronic cognitive impairment. These tools demonstrated high reliability and validity, supporting their clinical use.
CONCLUSIONS: These findings provide critical evidence for future ECT clinical guidelines in managing MDD. The recommended tools can aid clinicians in adjusting ECT regimens, identifying early cognitive changes, and improving therapeutic outcomes in MDD treatment.
摘要：
背景：重度抑郁症（MDD）影响全球3.5亿人。电惊厥治疗（ECT）是有效的，然而，缺乏对治疗后认知评估的研究。本研究系统地回顾和荟萃分析了ECT后认知评估工具优化MDD治疗的有效性。
方法：遵循PRISMA指南，本综述已在PROSPERO(CRD42023470318)上预先注册。截至2023年11月12日，在9个数据库中进行了搜索。使用Cochrane偏倚风险工具进行随机对照试验（RCT）和准实验研究的质量评估，JBI关键评估工具，和Jadad量表。短期和长期认知功能的荟萃分析涉及24和18个工具，分别。
结果：评估了30项研究（20项RCT和10项准实验性），涉及2462例MDD患者。结果表明，ECT后总体短期和长期认知功能没有显着差异。短期分析显示记忆受损，学习,和言语能力，但注意力和处理速度的提高。长期分析显示记忆力增强，学习,口头,和视觉空间能力与基线相比。根据等级分类，我们推荐11种评估急性认知功能的工具和10种评估慢性认知障碍的工具.这些工具表现出很高的可靠性和有效性，支持其临床使用。
结论：这些发现为未来ECT治疗MDD的临床指南提供了重要证据。推荐的工具可以帮助临床医生调整ECT方案，识别早期认知变化，并改善MDD治疗的治疗结果。
方法：遵循PRISMA指南，本综述已在PROSPERO(CRD42023470318)上预先注册。截至2023年11月12日，在9个数据库中进行了搜索。使用Cochrane偏倚风险工具进行随机对照试验（RCT）和准实验研究的质量评估，JBI关键评估工具，和Jadad量表。短期和长期认知功能的荟萃分析涉及24和18个工具，分别。
结果：评估了30项研究（20项RCT和10项准实验性），涉及2462例MDD患者。结果表明，ECT后总体短期和长期认知功能没有显着差异。短期分析显示记忆受损，学习,和言语能力，但注意力和处理速度的提高。长期分析显示记忆力增强，学习,口头,和视觉空间能力与基线相比。根据等级分类，我们推荐11种评估急性认知功能的工具和10种评估慢性认知障碍的工具.这些工具表现出很高的可靠性和有效性，支持其临床使用。
结论：这些发现为未来ECT治疗MDD的临床指南提供了重要证据。推荐的工具可以帮助临床医生调整ECT方案，识别早期认知变化，并改善MDD治疗的治疗结果。
