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Published on: August 15, 2017
Anti-inflammatory Effect of Electroconvulsive Therapy and Association Between Brain-Derived Neurotrophic Factor
Kazuya Okuhira1,2, Shun Takahashi1,3,4,5, Shohei Funai1
1Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan.
Background:
Electroconvulsive therapy (ECT) is effective for severe psychiatric disorders, but relapse after a successful acute course of ECT remains common. Identification of biological predictors of relapse is therefore clinically important. In this exploratory prospective study, we investigated changes in inflammatory and neurogenesis-related biomarkers following an acute course of ECT, and examined their association with relapse during 1-year follow-up.
Methods:
Enrolled were 30 patients with major depressive disorder, bipolar disorder, or schizophrenia spectrum disorders who received their first acute course of bitemporal ECT. Clinical assessments and venous blood sampling were conducted before and after the ECT course. We measured serum inflammatory markers, anti-inflammatory factors, and brain-derived neurotrophic factor (BDNF). Relapse was prospectively evaluated using monthly Clinical Global Impression-Severity assessments over 1 year. Repeated-measures analyses were performed to examine biomarker changes and their interaction with relapse status.
Results:
Following the acute ECT course, 48.1% of patients achieved remission, and 37.0% experienced relapse during 1-year follow-up. ECT was associated with a significant decrease in serum soluble interleukin-2 receptor levels and significant increases in eicosapentaenoic acid and docosahexaenoic acid, indicating an anti-inflammatory effect. Notably, serum BDNF levels increased in the nonrelapse group but decreased in the relapse group, with a significant time-by-relapse interaction.
Conclusion:
An acute course of ECT is associated with anti-inflammatory biological changes and differential modulation of serum BDNF. Increases in BDNF after ECT may be linked to a reduced risk of relapse, suggesting that serum BDNF could be a potential prognostic biomarker for long-term outcomes following ECT.
