Effects of Electroconvulsive Therapy on Some Inflammatory Factors in Patients With Treatment-Resistant Schizophrenia

Electroconvulsive therapy (ECT) is the most effective option for several psychiatric conditions, including treatment-resistant schizophrenia. However, little is known about the molecular mechanism of action of ECT. The link between inflammatory system and schizophrenia is the focus of recent studies. However, the impact of ECT on inflammatory functioning in this disorder remains elusive. Whether ECT could modulate inflammatory factors in patients with schizophrenia was examined.

Plasma levels of interleukin-4 (IL-4), transforming growth factor-β (TGF-β), myeloperoxidase (MPO), and nuclear factor-κB (NF-κB) activation were analyzed in 20 schizophrenic patients, mainly with resistant to antipsychotic medication disorders, and in 20 sex- and age-matched healthy controls. Disease severity was evaluated using the Brief Psychiatric Rating Scale. All patients were followed with measurement of the inflammatory factors before and after ECT treatment and compared with the controls.

Patients with schizophrenia had markedly raised NF-κB and but decreased TGF-β levels compared with healthy controls. On the other hand, no significant differences were found for the levels of IL-4 and MPO levels. The clinical improvement during repeated ECT was accompanied by a gradual and significant increase in IL-4 and TGF-β level, but MPO and NF-κB activation were left unaffected. Increases in TGF-β were negatively correlated with the change in Brief Psychiatric Rating Scale scores after ECT.

It is shown that ECT, while increasing the anti-inflammatory response such as the levels of IL-4 and TGF-β, it did not affect the levels of MPO and NF-κB activation in this study.