Electroconvulsive therapy (ECT) increases serum hypoxia‑inducible factor‑1 alpha (HIF- 1α) in depressed patients

Hypoxia has been shown to cause disturbances in neurohormonal regulation in the brain and may play an important role in the pathophysiology of depression. Hence, this study aimed to evaluate the relationship between electroconvulsive therapy (ECT) and hypoxia-inducible factor-1 alpha (HIF-1α) activation and propose a perspective on the potential role of HIF-1α in the treatment of major depressive disorder (MDD).

Twenty patients diagnosed with MDD who underwent ECT and 25 healthy controls who did not undergo any treatment were included in the study. Serum HIF-1α levels in peripheral blood samples taken from the patients both before ECT (pre-test) and after (post-test) were compared with those in the control group. The Hamilton Depression Rating Scale (HDRS), Clinical Global Impression-Severity (CGI-S) scale, and sociodemographic data form were administered to all the patients.

The HIF-1α values in the patient group pre-test were significantly lower than in the control group (p = 0.008). The HIF-1α levels in the patient group post-test were significantly higher than pre-test (p < 0.001). There was no difference between the HIF-1α levels in the patient group post-test and the control group (p > 0.05).

To our knowledge, this is the first research to investigate serum HIF-1α changes in MDD patients undergoing ECT. The study demonstrated that ECT treatment in MDD patients leads to an increase in HIF-1α levels and suggests that HIF-1α may contribute to the antidepressant mechanism of ECT.