目的:探讨电惊厥治疗(ECT)对难治性精神分裂症(TRS)患者的客观认知效果。
数据源:MEDLINE的数据库搜索,PsycINFO,Embase于2022年9月22日进行,使用搜索词“精神分裂症”和“电惊厥疗法”。搜索仅限于1985年至今发表的文章,在英语中,和人类研究。
研究选择:共鉴定了4293篇文章。经过标题和全文筛选,17条符合资格标准。受控,开放标签,和急性的回顾性研究,维护,或继续ECT包括在内。客观的认知测量必须是研究的主要或次要结果,没有其他干预措施,除了标准的护理治疗(即,抗精神病药)。
数据提取:有关研究设计的数据,提供的ECT类型,认知结果测量,并提取ECT前后认知表现的变化。结果以叙述性回顾的形式呈现。
结果:总体,在全球认知领域的TRS参与者中,ECT与任何明显的认知缺陷无关,注意,语言,视觉空间功能,和执行功能。对记忆的直接影响的发现是模棱两可的,但是大多数研究发现治疗后记忆力没有改变或改善。
结论:目前的证据支持以下结论:在TRS患者中,ECT对认知没有长期的负面影响。较大,需要假对照试验来支持这些结论.这篇综述中的所有研究都评估了ECT对抗精神病药的辅助作用;因此,ECT独立于抗精神病药物的认知效应仍不清楚.
Objective: To determine the objective cognitive effects of electroconvulsive therapy (ECT) in treatment-resistant schizophrenia (TRS).
Data Sources: A database search of MEDLINE, PsycINFO, and Embase was conducted on September 22, 2022, using the search terms \"schizophrenia\" and \"electroconvulsive therapy.\" The search was limited to the articles published from 1985 to present, in English, and human studies.
Study Selection: A total of 4293 articles were identified. After screening by title and full text, 17 articles met eligibility criteria. Controlled, open-label, and retrospective studies of acute, maintenance, or continuation ECT were included. An objective cognitive measure(s) had to be the primary or secondary outcome of the study, with no other interventions administered, besides standard-of-care treatment (ie, antipsychotics).
Data Extraction: Data regarding the study design, type of ECT provided, cognitive outcome measures, and change in cognitive performance pre- to post-ECT were extracted. Results are presented as a narrative
review.
Results: Overall, ECT was not associated with any significant cognitive deficits in participants with TRS across the domains of global cognition, attention, language, visuospatial function, and executive function. Findings for immediate effects on memory were equivocal, but the majority of studies found no change or an improvement in memory after treatment.
Conclusions: The current evidence supports the conclusion that ECT does not have negative long-term effects on cognition among patients with TRS. Larger, sham-controlled trials are needed to support these conclusions. All studies in this
review assessed ECT adjunct to antipsychotics; therefore, the cognitive effects of ECT independent of antipsychotics remain unclear.