1
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Hsieh MH. Electroconvulsive therapy for treatment-resistant depression. PROGRESS IN BRAIN RESEARCH 2023; 281:69-90. [PMID: 37806717 DOI: 10.1016/bs.pbr.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Electroconvulsive therapy (ECT), the oldest brain stimulation procedure in psychiatry, is associated with rapid response and remission in majority of patients with resistant, severe, and sometimes life-threatening depression. ECT has been included as an essential component in the definition of treatment-resistant depression (TRD) to display the course and diversification of TRD. On the other hand, ECT remains the treatment of choice for the most severe incapacitating forms of TRD and is a cost-effective treatment. In this chapter, we reviewed some essential studies, meta-analysis, and expert guidelines regarding ECT in TRD. ECT should not be considered as a treatment of last resort, and its administration should be considered on the basis of individual patient and illness factors. The clinical role of ECT vs other neurostimulation treatments for TRD, that is, repetitive transcranial magnetic stimulation, were also explored. Much effort has been directed toward the clinical and basic research about mechanisms of action of ECT in depression. A thorough understanding of the neurobiological effects of ECT may increase our understanding of its therapeutic effects, ultimately leading to improved patient care. We also showed that the distinct mechanisms of ECT in biological treatments of major depressive disorder (MDD) and some recent approaches to understand this most common psychiatric disorder. ECT should remain a standard part of modern psychiatric medicine. We recommend a more careful and thoughtful application of this traditional but effective technology.
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Affiliation(s)
- Ming H Hsieh
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
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2
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Ji GJ, Li J, Liao W, Wang Y, Zhang L, Bai T, Zhang T, Xie W, He K, Zhu C, Dukart J, Baeken C, Tian Y, Wang K. Neuroplasticity-Related Genes and Dopamine Receptors Associated with Regional Cortical Thickness Increase Following Electroconvulsive Therapy for Major Depressive Disorder. Mol Neurobiol 2023; 60:1465-1475. [PMID: 36469225 DOI: 10.1007/s12035-022-03132-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/08/2022] [Indexed: 12/08/2022]
Abstract
Electroconvulsive therapy (ECT) is an effective neuromodulatory therapy for major depressive disorder (MDD). Treatment is associated with regional changes in brain structure and function, indicating activation of neuroplastic processes. To investigate the underlying neurobiological mechanism of macroscopic reorganization following ECT, we longitudinally (before and after ECT in two centers) collected magnetic resonance images for 96 MDD patients. Similar patterns of cortical thickness (CT) changes following ECT were observed in two centers. These CT changes were spatially colocalized with a weighted combination of genes enriched for neuroplasticity-related ontology terms and pathways (e.g., synaptic pruning) as well as with a higher density of D2/3 dopamine receptors. A multiple linear regression model indicated that the region-specific gene expression and receptor density patterns explained 40% of the variance in CT changes after ECT. In conclusion, these findings suggested that dopamine signaling and neuroplasticity-related genes are associated with the ECT-induced morphological reorganization.
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Affiliation(s)
- Gong-Jun Ji
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, China. .,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China. .,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China. .,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Anhui Province, Hefei, 230032, China.
| | - Jiao Li
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610000, China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 610000, China
| | - Wei Liao
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610000, China.,MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, 610000, China
| | - Yingru Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Anhui Province, Hefei, 230032, China
| | - Lei Zhang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Anhui Province, Hefei, 230032, China
| | - Tongjian Bai
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Anhui Province, Hefei, 230032, China
| | - Ting Zhang
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Anhui Province, Hefei, 230032, China.,Department of Psychiatry, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wen Xie
- Department of Psychiatry, Anhui Mental Health Center, Hefei, 230022, China
| | - Kongliang He
- Department of Psychiatry, Anhui Mental Health Center, Hefei, 230022, China
| | - Chuyan Zhu
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China.,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Anhui Province, Hefei, 230032, China
| | - Juergen Dukart
- Institute of Neuroscience and Medicine, Brain and Behaviour, Research Centre Jülich, INM-7), Jülich, Germany.,Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, 40210, Düsseldorf, Germany
| | - Chris Baeken
- Experimental Psychiatry Lab, Department of Head and Skin, Ghent University, Ghent, Belgium.,Department of Psychiatry, Free University Brussels, Brussels, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Yanghua Tian
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University , Hefei, China.
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, China. .,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China. .,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China. .,Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Anhui Province, Hefei, 230032, China. .,Anhui Institute of Translational Medicine, Hefei, China.
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3
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Mu X, Xu J, Lin P, Luo Y, Zhu Y, Shi Y, Chen S, Wu Z, Li S. A Case Report of Leukocytosis During Modified Electroconvulsive Therapy of Paranoid Personality Disorder. Front Psychiatry 2022; 13:899847. [PMID: 35693976 PMCID: PMC9186336 DOI: 10.3389/fpsyt.2022.899847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Modified electroconvulsive therapy (MECT) is a viable therapeutic option for patients with mood disorders and schizophrenia. We found that there is a relationship between MECT and leukocytosis. To the best of our knowledge, this is the first case of this problem. There are no relevant guidelines recommending the risk of leukocytosis caused by MECT, nor the method to reduce the risk. We hope to share this case to provide a reference for the prevention and treatment of similar patients with leukocytosis during or after MECT and remind psychiatrists to pay attention to this risk of leukocytosis before making the decision of MECT while knowing how to deal with it. CASE PRESENTATION We describe a case of a 24-year-old woman diagnosed with Paranoid personality disorder (PPD) whose symptoms began at 19 years old. Her main clinical manifestations are feeling targeted, cheated, tracked, misunderstood, and repeating action. Since antipsychotic treatment was ineffective, we considered MECT. After MECT, the patient's body temperature increased, and leukocytosis was found. After excluding infection and other possibilities, we added 1,000 ml physiological saline to the patient through the vein. The white blood cell (WBC) count returned to normal in a short time. CONCLUSION Before MECT, it is necessary to screen blood cytology. During and after MECT, we should be alert to leukocytosis that may be related to MECT and deal with it correctly in time.
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Affiliation(s)
- Xingyu Mu
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Jiao Xu
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Peilin Lin
- The University of Edinburgh, Edinburgh, United Kingdom
| | - Ya Luo
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuan Zhu
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Yi Shi
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Shangtao Chen
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Zengxiang Wu
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Shuangqing Li
- Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
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Maffioletti E, Carvalho Silva R, Bortolomasi M, Baune BT, Gennarelli M, Minelli A. Molecular Biomarkers of Electroconvulsive Therapy Effects and Clinical Response: Understanding the Present to Shape the Future. Brain Sci 2021; 11:brainsci11091120. [PMID: 34573142 PMCID: PMC8471796 DOI: 10.3390/brainsci11091120] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/28/2022] Open
Abstract
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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Affiliation(s)
- Elisabetta Maffioletti
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (E.M.); (R.C.S.); (M.G.)
| | - Rosana Carvalho Silva
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (E.M.); (R.C.S.); (M.G.)
| | | | - Bernhard T. Baune
- Department of Psychiatry and Psychotherapy, University of Münster, 48149 Münster, Germany;
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Parkville, VIC 3010, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (E.M.); (R.C.S.); (M.G.)
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy; (E.M.); (R.C.S.); (M.G.)
- Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy
- Correspondence: ; Tel.: +39-030-3717255; Fax: +39-030-3701157
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5
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Soda T, McLoughlin DM, Clark SR, Oltedal L, Kessler U, Haavik J, Bousman C, Smith DJ, Bioque M, Clements CC, Loo C, Vila-Rodriguez F, Minelli A, Mickey BJ, Milev R, Docherty AR, Langan Martin J, Achtyes ED, Arolt V, Redlich R, Dannlowski U, Cardoner N, Clare E, Craddock N, Di Florio A, Dmitrzak-Weglarz M, Forty L, Gordon-Smith K, Husain M, Ingram WM, Jones L, Jones I, Juruena M, Kirov G, Landén M, Müller DJ, Nordensköld A, Pålsson E, Paul M, Permoda A, Pliszka B, Rea J, Schubert KO, Sonnen JA, Soria V, Stageman W, Takamiya A, Urretavizacaya M, Watson S, Zavorotny M, Young AH, Vieta E, Rybakowski JK, Gennarelli M, Zandi PP, Sullivan PF, Baune BT. International Consortium on the Genetics of Electroconvulsive Therapy and Severe Depressive Disorders (Gen-ECT-ic). Eur Arch Psychiatry Clin Neurosci 2020; 270:921-932. [PMID: 31802253 PMCID: PMC7385979 DOI: 10.1007/s00406-019-01087-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 11/16/2019] [Indexed: 02/05/2023]
Abstract
Recent genome-wide association studies have demonstrated that the genetic burden associated with depression correlates with depression severity. Therefore, conducting genetic studies of patients at the most severe end of the depressive disorder spectrum, those with treatment-resistant depression and who are prescribed electroconvulsive therapy (ECT), could lead to a better understanding of the genetic underpinnings of depression. Despite ECT being one of the most effective forms of treatment for severe depressive disorders, it is usually placed at the end of treatment algorithms of current guidelines. This is perhaps because ECT has controlled risk and logistical demands including use of general anaesthesia and muscle relaxants and side-effects such as short-term memory impairment. Better understanding of the genetics and biology of ECT response and of cognitive side-effects could lead to more personalized treatment decisions. To enhance the understanding of the genomics of severe depression and ECT response, researchers and ECT providers from around the world and from various depression or ECT networks, but not limited to, such as the Psychiatric Genomics Consortium, the Clinical Alliance and Research in ECT, and the National Network of Depression Centers have formed the Genetics of ECT International Consortium (Gen-ECT-ic). Gen-ECT-ic will organize the largest clinical and genetic collection to date to study the genomics of severe depressive disorders and response to ECT, aiming for 30,000 patients worldwide using a GWAS approach. At this stage it will be the largest genomic study on treatment response in depression. Retrospective data abstraction and prospective data collection will be facilitated by a uniform data collection approach that is flexible and will incorporate data from many clinical practices. Gen-ECT-ic invites all ECT providers and researchers to join its efforts.
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Affiliation(s)
- Takahiro Soda
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Declan M McLoughlin
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Scott R Clark
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Leif Oltedal
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Radiology, Mohn Medical Imaging and Visualization Centre, Haukeland University Hospital, Bergen, Norway
| | - Ute Kessler
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Haukeland University Hospital, Bergen, Norway
| | - Jan Haavik
- Haukeland University Hospital, Bergen, Norway
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Chad Bousman
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Daniel J Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Miquel Bioque
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | | | - Colleen Loo
- School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
- Sydney Neurostimulation Centre, Black Dog Institute, Randwick, NSW, Australia
| | - Fidel Vila-Rodriguez
- Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Brian J Mickey
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Roumen Milev
- Departments of Psychiatry and Psychology, Queen's University, Kingston, ON, Canada
- Providence Care Hospital, Kingston, ON, Canada
| | - Anna R Docherty
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Eric D Achtyes
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Ronny Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Narcis Cardoner
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut D'INVESTIGACIÓ i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Emily Clare
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nick Craddock
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Arianna Di Florio
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | - Liz Forty
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | | | - Wendy M Ingram
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lisa Jones
- Psychological Medicine, University of Worcester, Worcester, UK
| | - Ian Jones
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Mario Juruena
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - George Kirov
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the Gothenburg University, Gothenburg, Sweden
| | - Daniel J Müller
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Axel Nordensköld
- Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden
| | - Erik Pålsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the Gothenburg University, Gothenburg, Sweden
| | - Meethu Paul
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Agnieszka Permoda
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Bartlomiej Pliszka
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jamie Rea
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Klaus O Schubert
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Northern Adelaide Mental Health Service, Salisbury, SA, Australia
| | - Joshua A Sonnen
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Virginia Soria
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - Will Stageman
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Institute of Neuroscience, Newcastle University and NTW NHS Trust, Newcastle, UK
| | - Akihiro Takamiya
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Stuart Watson
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Institute of Neuroscience, Newcastle University and NTW NHS Trust, Newcastle, UK
| | - Maxim Zavorotny
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Allan H Young
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
- Department of Psychiatric Nursing, Poznan University of Medical Sciences, Poznan, Poland
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Genetic Unit, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patrick F Sullivan
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
- Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany.
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia.
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia.
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6
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Herzog DP, Wegener G, Lieb K, Müller MB, Treccani G. Decoding the Mechanism of Action of Rapid-Acting Antidepressant Treatment Strategies: Does Gender Matter? Int J Mol Sci 2019; 20:ijms20040949. [PMID: 30813226 PMCID: PMC6412361 DOI: 10.3390/ijms20040949] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/15/2019] [Accepted: 02/19/2019] [Indexed: 12/19/2022] Open
Abstract
Gender differences play a pivotal role in the pathophysiology and treatment of major depressive disorder. This is strongly supported by a mean 2:1 female-male ratio of depression consistently observed throughout studies in developed nations. Considering the urgent need to tailor individualized treatment strategies to fight depression more efficiently, a more precise understanding of gender-specific aspects in the pathophysiology and treatment of depressive disorders is fundamental. However, current treatment guidelines almost entirely neglect gender as a potentially relevant factor. Similarly, the vast majority of animal experiments analysing antidepressant treatment in rodent models exclusively uses male animals and does not consider gender-specific effects. Based on the growing interest in innovative and rapid-acting treatment approaches in depression, such as the administration of ketamine, its metabolites or electroconvulsive therapy, this review article summarizes the evidence supporting the importance of gender in modulating response to rapid acting antidepressant treatment. We provide an overview on the current state of knowledge and propose a framework for rodent experiments to ultimately decode gender-dependent differences in molecular and behavioural mechanisms involved in shaping treatment response.
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Affiliation(s)
- David P Herzog
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
- Focus Program Translational Neurosciences, Johannes Gutenberg University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany.
| | - Gregers Wegener
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Skovagervej 2, 8240 Risskov, Denmark.
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
- Focus Program Translational Neurosciences, Johannes Gutenberg University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany.
| | - Marianne B Müller
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
- Focus Program Translational Neurosciences, Johannes Gutenberg University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany.
| | - Giulia Treccani
- Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
- Focus Program Translational Neurosciences, Johannes Gutenberg University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany.
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Skovagervej 2, 8240 Risskov, Denmark.
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7
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Foo JC, Streit F, Frank J, Witt SH, Treutlein J, Baune BT, Moebus S, Jöckel K, Forstner AJ, Nöthen MM, Rietschel M, Sartorius A, Kranaster L. Evidence for increased genetic risk load for major depression in patients assigned to electroconvulsive therapy. Am J Med Genet B Neuropsychiatr Genet 2019; 180:35-45. [PMID: 30507021 PMCID: PMC6368636 DOI: 10.1002/ajmg.b.32700] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/21/2018] [Accepted: 10/19/2018] [Indexed: 12/27/2022]
Abstract
Electroconvulsive therapy (ECT) is the treatment of choice for severe and treatment-resistant depression; disorder severity and unfavorable treatment outcomes are shown to be influenced by an increased genetic burden for major depression (MD). Here, we tested whether ECT assignment and response/nonresponse are associated with an increased genetic burden for major depression (MD) using polygenic risk score (PRS), which summarize the contribution of disease-related common risk variants. Fifty-one psychiatric inpatients suffering from a major depressive episode underwent ECT. MD-PRS were calculated for these inpatients and a separate population-based sample (n = 3,547 healthy; n = 426 self-reported depression) based on summary statistics from the Psychiatric Genomics Consortium MDD-working group (Cases: n = 59,851; Controls: n = 113,154). MD-PRS explained a significant proportion of disease status between ECT patients and healthy controls (p = .022, R2 = 1.173%); patients showed higher MD-PRS. MD-PRS in population-based depression self-reporters were intermediate between ECT patients and controls (n.s.). Significant associations between MD-PRS and ECT response (50% reduction in Hamilton depression rating scale scores) were not observed. Our findings indicate that ECT cohorts show an increased genetic burden for MD and are consistent with the hypothesis that treatment-resistant MD patients represent a subgroup with an increased genetic risk for MD. Larger samples are needed to better substantiate these findings.
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Affiliation(s)
- Jerome C. Foo
- Central Institute of Mental Health, Department of Genetic Epidemiology in PsychiatryMedical Faculty Mannheim, University of HeidelbergMannheimGermany
| | - Fabian Streit
- Central Institute of Mental Health, Department of Genetic Epidemiology in PsychiatryMedical Faculty Mannheim, University of HeidelbergMannheimGermany
| | - Josef Frank
- Central Institute of Mental Health, Department of Genetic Epidemiology in PsychiatryMedical Faculty Mannheim, University of HeidelbergMannheimGermany
| | - Stephanie H. Witt
- Central Institute of Mental Health, Department of Genetic Epidemiology in PsychiatryMedical Faculty Mannheim, University of HeidelbergMannheimGermany
| | - Jens Treutlein
- Central Institute of Mental Health, Department of Genetic Epidemiology in PsychiatryMedical Faculty Mannheim, University of HeidelbergMannheimGermany
| | | | - Bernhard T. Baune
- Department of PsychiatryMelbourne Medical School, The University of MelbourneMelbourneVictoriaAustralia
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and EpidemiologyUniversity Hospital Essen, University Duisburg‐EssenEssenGermany
| | - Karl‐Heinz Jöckel
- Institute for Medical Informatics, Biometry and EpidemiologyUniversity Hospital Essen, University Duisburg‐EssenEssenGermany
| | - Andreas J. Forstner
- Institute of Human GeneticsUniversity of Bonn School of Medicine & University Hospital BonnBonnGermany
- Department of Genomics, Life & Brain Research CenterUniversity of BonnBonnGermany
| | - Markus M. Nöthen
- Institute of Human GeneticsUniversity of Bonn School of Medicine & University Hospital BonnBonnGermany
- Department of Genomics, Life & Brain Research CenterUniversity of BonnBonnGermany
| | - Marcella Rietschel
- Central Institute of Mental Health, Department of Genetic Epidemiology in PsychiatryMedical Faculty Mannheim, University of HeidelbergMannheimGermany
| | - Alexander Sartorius
- Central Institute of Mental Health, Department of Psychiatry and PsychotherapyMedical Faculty Mannheim, University of HeidelbergMannheimGermany
| | - Laura Kranaster
- Central Institute of Mental Health, Department of Psychiatry and PsychotherapyMedical Faculty Mannheim, University of HeidelbergMannheimGermany
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Guo YF, Fu HB, Liu ZY, Lu W, Luo KY, Zhu HR, Ning WD, Chen F, Yang LY, Zhou XD. Effects of the modified electric convulsive treatment (MECT) on cell factors of schizophrenia. Exp Ther Med 2017; 13:873-876. [PMID: 28450912 PMCID: PMC5403391 DOI: 10.3892/etm.2017.4075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 11/10/2016] [Indexed: 11/06/2022] Open
Abstract
The expression of cell factors of schizophrenia and the effect of the modified electric convulsive treatment (MECT) were studied. In total, 156 patients with schizophrenia were selected, and divided into the drug group (70 cases) and the drug combined with MECT group (combined group) (86 cases) according to the treatment methods. In addition, 70 cases of healthy volunteers (control group) were selected according to the closest matching method based on 1:1 of age and gender. The drug treatment, consisted of anti-psychotic drugs, such as risperidone 2-8, quetiapine 300-750, ziprasidone 80-160 or aripiprazole 10-30 mg/day, and for the control group, we used the electric spasm therapeutic instrument, Thymatron®IV Systems up to 6 times, 3 times a week. The levels of interleukin (IL)-10, IL-4, IL-6 and IL-1 were detected before and after treatment by ELISA. The positive and negative symptom scale (PANSS) was used to evaluate the efficiency. Before the treatment, IL-1 and IL-6 levels of drug and combined groups were significantly higher than those of the control group (P<0.05), while IL-4 and IL-10 had no difference with the control group. There was no significant difference of each factor between the drug and combined groups. After treatment, IL-1, IL-6 and IL-10 of the drug group did not change compared to the levels before treatment, but IL-4 increased significantly; IL-1 and IL-10 of the combined group did not change, while IL-4 and IL-6 increased significantly; IL-1, IL-4 and IL-6 of the drug and combined groups were significantly (P<0.05) higher than those in the control group, but not IL-10. IL-1, IL-4 and IL-6 levels of the combined group were significantly higher (P<0.05) than those of the drug group. After treatment, the PANSS scores of the two groups decreased and the combined group decreased more significantly (P<0.05). The reduction rate of the combined group was significantly higher (P<0.05) than that of the drug group. The total efficiency of the combined group was significantly higher than that of the drug group, and after comparing these levels, there was statistical significance (P<0.05). IL-1, IL-4, IL-6 and IL-10 levels of the drug and combined groups before treatment were not associated with PANSS scores and the variation of IL-1, IL-4, IL-6 and IL-10 of the drug and combined groups had no correlation with the reduction rate of the PANSS. The results showed that, cell factors of schizophrenia had an abnormal expression, and medication and MECT can affect the expression level. In addition, MECT can improve the effect in the treatment of schizophrenia, but had no obvious correlation with the change of cell factors.
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Affiliation(s)
- Yong-Fang Guo
- 256th Clinical Department of Bethune International Peace Hospital of PLA, Zhengding, Hebei 050800, P.R. China
| | - Hua-Bin Fu
- 256th Clinical Department of Bethune International Peace Hospital of PLA, Zhengding, Hebei 050800, P.R. China
| | - Zhi-Yuan Liu
- 256th Clinical Department of Bethune International Peace Hospital of PLA, Zhengding, Hebei 050800, P.R. China
| | - Wei Lu
- 256th Clinical Department of Bethune International Peace Hospital of PLA, Zhengding, Hebei 050800, P.R. China
| | - Ke-Yong Luo
- 256th Clinical Department of Bethune International Peace Hospital of PLA, Zhengding, Hebei 050800, P.R. China
| | - Hong-Ri Zhu
- 256th Clinical Department of Bethune International Peace Hospital of PLA, Zhengding, Hebei 050800, P.R. China
| | - Wei-Dong Ning
- 256th Clinical Department of Bethune International Peace Hospital of PLA, Zhengding, Hebei 050800, P.R. China
| | - Feng Chen
- 256th Clinical Department of Bethune International Peace Hospital of PLA, Zhengding, Hebei 050800, P.R. China
| | - Li-Yu Yang
- 256th Clinical Department of Bethune International Peace Hospital of PLA, Zhengding, Hebei 050800, P.R. China
| | - Xiao-Dong Zhou
- 256th Clinical Department of Bethune International Peace Hospital of PLA, Zhengding, Hebei 050800, P.R. China
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