Inflammation and remission in older patients with depression treated with electroconvulsive therapy; findings from the MODECT study✰

Carlier, Angela; Berkhof, Johanna G.; Rozing, Maarten P.; Bouckaert, Filip; Sienaert, Pascal; Eikelenboom, Piet; Veerhuis, Robert; Vandenbulcke, Mathieu; Berkhof, Johannes; Stek, Max L.; Rhebergen, Didi; Dols, Annemiek; Exel, Eric van

doi:10.1016/j.jad.2019.06.040

Cited by 24 publications

(19 citation statements)

References 58 publications

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“…Higher inflammation is associated with poorer response to most antidepressant strategies [15][16][17][18][19] , and thus may be of particular relevance in the study of TRD. Interestingly, while higher inflammation has been associated with poorer outcome to many pharmacologic treatments for depression, the inverse relationship has been found for treatment responsiveness to electroconvulsive therapy (ECT) 20,21 , an intervention used primarily for TRD or other severe mood disorders (e.g. catatonia, psychotic depression).…”

Section: Introductionmentioning

confidence: 99%

Depression treatment response to ketamine: sex-specific role of interleukin-8, but not other inflammatory markers

et al. 2021

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Inflammation plays a role in depression pathophysiology and treatment response, with effects varying by sex and therapeutic modality. Lower levels of interleukin(IL)-8 predict depression response to antidepressant medication and to electroconvulsive therapy (ECT), although ECT effects are specific to females. Whether IL-8 predicts depression response to ketamine and in a sex-specific manner is not known. Here, depressed patients (n = 46; female, n = 17) received open label infusion of ketamine (0.5 mg/kg over 40 min; NCT02165449). Plasma levels of IL-8 were evaluated at baseline and post-treatment. Baseline levels of IL-8 had a trending association with response to ketamine, depending upon sex (responder status × sex interaction: p = 0.096), in which lower baseline levels of IL-8 in females (p = 0.095) but not males (p = 0.96) trended with treatment response. Change in levels of IL-8 from baseline to post-treatment differed significantly by responder status (defined as ≥50% reduction in Hamilton Depression Rating Scale [HAM-D] Score), depending upon sex (responder status × sex × time interaction: F(1,42)=6.68, p = 0.01). In addition, change in IL-8 interacted with sex to predict change in HAM-D score (β = -0.63, p = 0.003); increasing IL-8 was associated with decreasing HAM-D score in females (p = 0.08) whereas the inverse was found in males (p = 0.02). Other inflammatory markers (IL-6, IL-10, tumor necrosis factor-α, C-reactive protein) were explored with no significant relationships identified. Given these preliminary findings, further evaluation of sex differences in the relationship between IL-8 and treatment response is warranted to elucidate mechanisms of response and aid in the development of personalized approaches to depression treatment.

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Section: Introductionmentioning

confidence: 99%

Depression treatment response to ketamine: sex-specific role of interleukin-8, but not other inflammatory markers

et al. 2021

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“…[ 95,96] CRP: C-reactive protein; ECS: electroconvulsive seizure; ECT: electroconvulsive therapy; IL: interleukin; TNF: tumor necrosis factor; TRD: treatment-resistant depression.…”

Section: Inflammatory Markers Clinical Samplesmentioning

confidence: 99%

Molecular Biomarkers of Electroconvulsive Therapy Effects and Clinical Response: Understanding the Present to Shape the Future

et al. 2021

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Electroconvulsive therapy (ECT) represents an effective intervention for treatment-resistant depression (TRD). One priority of this research field is the clarification of ECT response mechanisms and the identification of biomarkers predicting its outcomes. We propose an overview of the molecular studies on ECT, concerning its course and outcome prediction, including also animal studies on electroconvulsive seizures (ECS), an experimental analogue of ECT. Most of these investigations underlie biological systems related to major depressive disorder (MDD), such as the neurotrophic and inflammatory/immune ones, indicating effects of ECT on these processes. Studies about neurotrophins, like the brain-derived neurotrophic factor (BDNF) and the vascular endothelial growth factor (VEGF), have shown evidence concerning ECT neurotrophic effects. The inflammatory/immune system has also been studied, suggesting an acute stress reaction following an ECT session. However, at the end of the treatment, ECT produces a reduction in inflammatory-associated biomarkers such as cortisol, TNF-alpha and interleukin 6. Other biological systems, including the monoaminergic and the endocrine, have been sparsely investigated. Despite some promising results, limitations exist. Most of the studies are concentrated on one or few markers and many studies are relatively old, with small sample sizes and methodological biases. Expression studies on gene transcripts and microRNAs are rare and genetic studies are sparse. To date, no conclusive evidence regarding ECT molecular markers has been reached; however, the future may be just around the corner.

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“…Depression is more closely associated with inflammatory diseases than with noninflammatory ones and a higher baseline inflammation has been linked to a decreased antidepressant treatment response [76]. On the other hand, low-grade inflammation at baseline predicts a better ECT response in old patients [77], and this it is unclear whether this link exists for all ages.…”

Section: Effects Of Ect On Inflammatory Processesmentioning

confidence: 99%

Differential Effects of Electroconvulsive Therapy in the Treatment of Major Depressive Disorder

et al. 2020

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Background/Aims/Methods: Electroconvulsive therapy (ECT) is still one of the most potent treatments in the acute phase of major depressive disorder (MDD) and particularly applied in patients considered treatment resistant. However, despite the frequent and widespread use of ECT for >70 years, the exact neurobiological mechanisms underlying its efficacy remain unclear. The present review aims to describe differential antidepressant and cognitive effects of ECT as well as effects on markers of neural activity and connectivity, neurochemistry, and inflammation that might underlie the treatment response and remission. Results: Region- specific changes in brain function and volume along with changes in concentrations of neurotransmitters and neuroinflammatory cytokines might serve as potential biomarkers for ECT outcomes. Conclusions: However, as current data is not consistent, future longitudinal investigations should combine modalities such as MRI, MR spectroscopy, and peripheral physiological measures to gain a deeper insight into interconnected time- and modality-specific changes in response to ECT.

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Inflammation and remission in older patients with depression treated with electroconvulsive therapy; findings from the MODECT study✰

Cited by 24 publications

References 58 publications

Depression treatment response to ketamine: sex-specific role of interleukin-8, but not other inflammatory markers

Depression treatment response to ketamine: sex-specific role of interleukin-8, but not other inflammatory markers

Molecular Biomarkers of Electroconvulsive Therapy Effects and Clinical Response: Understanding the Present to Shape the Future

Differential Effects of Electroconvulsive Therapy in the Treatment of Major Depressive Disorder

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