Neurobiological Mechanisms of Retrograde Amnesia Induced by Electroconvulsive Therapy: A Systematic Review

Electroconvulsive therapy (ECT) is a highly effective treatment for severe depression, yet it carries the significant burden of retrograde amnesia (RA), impacting personal memories and raising clinical concerns. This systematic review synthesizes evidence on the neurobiological underpinnings of this cognitive side effect. Our findings robustly indicate that ECT-induced RA is not a result of neuronal damage. Instead, it emerges from a complex interplay of transient neuroplastic changes. Key mechanisms include volumetric increases in the hippocampus linked to memory impairment, dysregulation of glutamatergic and glucocorticoid receptor pathways, inflammatory cytokine signaling, and disruptions in large-scale brain network connectivity. We propose a paradigm shift: viewing RA not as injury, but as a disruptive byproduct of the brain's profound, adaptive reorganization. This synthesis provides a cohesive framework for future research aimed at predicting and mitigating cognitive side effects to optimize the therapeutic use of ECT.

کلیدواژه ها:

Electroconvulsive Therapy ، Retrograde Amnesia ، Hippocampus ، Neuroplasticity ، Inflammation ، Functional Connectivity ، Cognitive Side Effects ، Memory