Die Elektrokonvulsionstherapie (EKT) besitzt durch ihren schnellen Wirkeintritt und hohe Ansprechrate einen großen Stellenwert in der Akuttherapie schwerer Verlaufsformen der Depression. Im Zuge der Behandlung lassen sich auch kognitive Veränderungen feststellen. Diese sind zum jetzigen Zeitpunkt noch unzureichend erforscht und werden kontrovers diskutiert. Auf dieser Beobachtung aufbauend soll festgestellt werden, welche Bereiche des Gedächtnisses betroffen sind und wie sich diese im Behandlungsverlauf präsentieren. Außerdem wird untersucht, ob ein linearer Zusammenhang zwischen der Gedächtnisleistung und der Depressionsschwere besteht und ob die Patienten auch subjektive Beschwerden der Merkfähigkeit äußern.
Background: Electroconvulsive therapy is of great importance in acute treatment for severe forms of depression. Cognitive changes can be identified in the course of the treatment. At the present, these have not been sufficiently researched and are viewed controversially. Based on this observation, we want to determine which areas of the memory are affected and how these changes present themselves. In addition, it is examined whether there is a linear connection between memory performance and the severity of depression and whether the patients also express subjective complaints of memory ability. Methods: In the period from 2011-2019, 187 patients were examined in the Clinic for Psychiatry and Psychotherapy on the Benjamin Franklin campus of the Charité Universitätsmedizin Berlin. Using cognitive tests, the memory performance was tested objectively and sub jectively at the time before the start (pre-electroconvulsive therapy) and at the end of the sessions (post-electroconvulsive therapy). Inclusion criteria contained total points ≥20 in the Montgomery-Åsberg Depression Rating Scale (MADRS), a unipolar course and a treatment number of ≥6 sessions. Demographic data were analyzed and a t-test for con nected samples of the memory parameters as well as a Pearson correlation between them and the Montgomery-Åsberg Depression Rating Scale were performed. Results: The depressive efficacy of the treatment was confirmed on the basis of an improvement of around 51%. A full remission, defined by the achievement of ≤10 total points in the Montgomery-Åsberg Depression Rating Scale, was found in 33%. In the "verbal learning and memory ability test" (VLMT), the runs "run (Durchgang) 1-5" were decreased by 5% (p≤,01), "run (Durchgang) 6" by 25% (p≤,001), "run (Durchgang) 7" by 26% (p≤,001) and "run (Durchgang) true-false (wahr-falsch)" by 39% (p≤,001). The run "Durchgang 1" and the subtest "Digit span forwards and backwards" were largely comparable. The "visual recall" improved by 6% (p≤,01) in the subitem ”immediately” and by 15% (p≤,001) in the "delayed" item. The subjective memory performance showed an increase of 22 %(p<,05). Before treatment there was a negative linear relationship between depression severity (shown through the Montgomery-Åsberg Depression Rating Scale) and the verbal learn ing and memory test (VLMT) runs "run (Durchgang) 1" (p≤,01), "run (Durchgang) 6" (p<,05) and "run (Durchgang) 7" (p<,05). Conclusion: The results of this study suggest a decrease in verbal memory, in particular the long-term component reproduced by the runs " run (Durchgang) 6", "run (Durchgang) 7" and "run (Durchgang) true-wrong (wahr-falsch)" and an increase in visual memory recall. The sub jective memory ability improved through the treatment. The changes examined are bidi rectional and further research into these observations is required.
