The pattern of inflammatory markers during electroconvulsive therapy in older depressed patients

Abstract

An association is found between changes in cytokine levels and antidepressant treatment outcome. Also, a proinflammatory profile is associated with a favourable electroconvulsive therapy (ECT) outcome. This paper investigates the pattern of inflammatory markers during a course of ECT in older depressed patients and whether this pattern is associated with ECT outcome. We hypothesized that ECT has an anti-inflammatory effect. MethodsThe pattern of CRP, IL-6, IL-10, and TNF-α during a course of ECT was examined using longitudinal mixed model analyses. Serum samples were collected in 99 older depressed patients (mean age: 72.88.3 years, MADRS score 33.89.0). ResultsAfter Bonferroni correction, there were no statistically significant alterations in levels of inflammatory markers during and after ECT. Effect sizes (Cohen's d) were -0.29 for CRP, -0.13 for IL-6, -0.06 for IL-10 and -0.07 for TNF-. Changes in CRP or cytokine levels did not differ between remitters and non-remitters. Median baseline levels of CRP were significantly higher in remitters. ConclusionsA small to medium effect size towards decreased CRP and IL-6 levels was observed. An antiinflammatory effect of ECT could not be confirmed. However, the findings may suggest that patients with an inflammatory profile benefit more from ECT than other patients. Further studies are needed to confirm these findings.

Human in vivo evidence of reduced astrocyte activation and neuroinflammation in patients with treatment‐resistant depression following electroconvulsive therapy

“…Several studies have demonstrated that ECT can lead to a long‐term reduction in peripheral cytokine levels, 18–21 suggesting an anti‐inflammatory effect. However, more recent studies have shown that ECT did not significantly alter the peripheral blood concentrations of the inflammatory mediators in depressed patients 22–24 . In animal models, where electroconvulsive shock (ECS) is used to mimic the human intervention, the effects of ECS on central inflammation have not fully been disentangled either.…”

“…However, more recent studies have shown that ECT did not significantly alter the peripheral blood concentrations of the inflammatory mediators in depressed patients. [22][23][24] In animal models, where electroconvulsive shock (ECS) is used to mimic the human intervention, the effects of ECS on central inflammation have not fully been disentangled either. Some studies have indicated that ECS can lead to astrocyte activation and an increase in inflammatory cytokines in the short term [25][26][27] ; however, these effects are rapid and may be transient.…”