| Objective : Major Depressive Disorder(MDD)is a chronic mood disorder with persistent depression as the main manifestation,often accompanied by cognitive impairment;circadian rhythm disorder is an important clinical feature of depression,and clinical studies have shown that cognitive impairment also has circadian rhythm changes during depressive episodes.Drug treatment of MDD has a slow onset and long course of treatment,and 30% to 50% of patients are not sensitive to drug treatment.Modified electroconvulsive therapy(MECT)has a fast onset and good curative effect in MDD.It has been widely recognized by the academic community and is currently recognized by many clinical guidelines as the most effective method for the treatment of refractory depression.However,MECT may cause cognitive impairment,especially its impact on memory,which limits its clinical use.However,there are still huge controversies at home and abroad as to whether the effect of MECT on memory function is improved or damaged,and how long it can last.Different studies have different conclusions,and the results are contradictory.There is a lack of dynamic assessment and research on cognitive function during MECT treatment,and there is also a failure to take into account the biorhythm of cognitive dysfunction in MDD.In this study,the influence of MECT on the cognitive function of MDD will be recognized and understood in the framework of biological diurnal rhythms.And the cognitive function of MDD will be dynamically evaluated by using the Cambridge Neuropsychological Test Automated Battery(CANTAB)to study the influence of MECT on the cognitive function of MDD.Methods:A total of 16 MDD were included in this study.Using the Hamilton Depression Scale(HAMD-24)and Hamilton Anxiety Scale(HAMA)to assess the degree of anxiety and depression of the patients.For cognition assessment,we used Pattern Recognition Memory(PRM),Paired Associative Learning(PAL),Spatial Span(SSP),and Spatial Working Memory(SWM)tests from the Cambridge Neuropsychological Test Automated Battery(CANTAB).Cognitive tests were performed at 8:30,14:30,and 20:30 on the day before MECT(T0),the first MECT(T1),and the last MECT(T2).Results : At T0,no significant difference was found between the memory function tests of patients with MDD.At T1,there is a significant difference(P<0.05)in the total number of errors in PAL task.Specifically,3-5 hours after treatment,the total number of errors was significantly higher than before treatment,but 8-10 hours after treatment,the total number of errors return to the baseline.At T2,there is a significant difference in the correct rate of PRM(delayed)task from morning to night(P < 0.05).More precisely,3-5 hours after treatment,significant improvement of the proportion correct in PRM,although there is a decline after 8-10 hours,it still shows an improvement trend compared with the baseline.And whether SSP and SWM are at T1 or T2,there is no significant difference between morning,afternoon and evening.There is a significant difference between T2 and T0 in the PRM(immediate)at 8:30(P<0.05),and showed a trend of gradual improvement;T1 and T0 at 14:30in the SSP showed a significant difference(P < 0.05),but There is no significant difference between T2 and T0.SSP is positively correlated with the improvement of anxiety symptoms in MDD;while PRM,PAL,SWM have no correlation with the improvement of anxiety and depression symptoms in MDD after MECT.After treatment of MECT,the scores of HAMA and HAMD were significantly reduced,and there was a significant difference(P<0.05).Conclusion : Modified electroconvulsive therapy can significantly improve the anxiety and depression symptoms of MDD.A single MECT can impair the visual memory and learning function of depression patients,but this damage usually disappears within 8-10 hours after treatment.And at the end of the treatment,we found that MECT can also improve the visual memory function of MDD. |
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