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Feenstra TC, la Cruz EKJ, Obbels J, Laroy M, Bouckaert F, Sienaert P, Oudega M, Dols A, van Exel E, Beekman ATF, Rhebergen D. The Cortisol Awakening Response as a Biomarker for Cognitive Side-Effects of Electroconvulsive Therapy. Am J Geriatr Psychiatry 2023; 31:991-995. [PMID: 37479670 DOI: 10.1016/j.jagp.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVE To test whether the cortisol awakening response (CAR) could be a biomarker for cognitive decline during electroconvulsive therapy (ECT). METHODS We studied 50 older patients with depression who were treated with ECT from the MODECT cohort. We used linear regression analyses to examine the association between CAR and cognitive change, assessed by the change in Mini Mental State Examination scores between baseline and 1 week after ECT course. CAR was assessed by the area under the curve of cortisol levels, according to Pruessner's-formula. Associations were adjusted for putative confounders, based on previous literature and availability. RESULTS We found no significant associations between the CAR and cognitive change during the ECT course in (un)adjusted models. CONCLUSION Our results indicate that the CAR is not usable as a biomarker for ECT-induced cognitive decline during ECT course. Further research in cohorts with larger samples is needed.
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Affiliation(s)
- Thomas C Feenstra
- GGZ Centraal Mental Health Care (TCF, EKJLC, DR), Amersfoort, The Netherlands; Amsterdam Public Health Research Institute, Mental Health Program (TCF, ATFB, DR), Amsterdam, The Netherlands.
| | - Eldon K J la Cruz
- GGZ Centraal Mental Health Care (TCF, EKJLC, DR), Amersfoort, The Netherlands
| | - Jasmien Obbels
- Department of Neurosciences (JO, ML, FB, PS), Academic Center for ECT and Neuromodulation (AcCENT), KU Leuven, University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Maarten Laroy
- Department of Neurosciences (JO, ML, FB, PS), Academic Center for ECT and Neuromodulation (AcCENT), KU Leuven, University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Filip Bouckaert
- Department of Neurosciences (JO, ML, FB, PS), Academic Center for ECT and Neuromodulation (AcCENT), KU Leuven, University Psychiatric Center KU Leuven, Leuven, Belgium; Department of Geriatric Psychiatry (FB), KU Leuven, University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Pascal Sienaert
- Department of Neurosciences (JO, ML, FB, PS), Academic Center for ECT and Neuromodulation (AcCENT), KU Leuven, University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Mardien Oudega
- Department of Psychiatry (MO, AD, ATFB, DR), Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; GGZ inGeest Mental Health Care (MO, EVE, ATFB), Amsterdam, The Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program (MO, AD, EVE), Amsterdam, The Netherlands
| | - Annemieke Dols
- Department of Psychiatry (AD), University Medical Centre Utrecht, Utrecht, The Netherlands; Department of Psychiatry (MO, AD, ATFB, DR), Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program (MO, AD, EVE), Amsterdam, The Netherlands
| | - Eric van Exel
- GGZ inGeest Mental Health Care (MO, EVE, ATFB), Amsterdam, The Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program (MO, AD, EVE), Amsterdam, The Netherlands
| | - Aartjan T F Beekman
- Amsterdam Public Health Research Institute, Mental Health Program (TCF, ATFB, DR), Amsterdam, The Netherlands; Department of Psychiatry (MO, AD, ATFB, DR), Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; GGZ inGeest Mental Health Care (MO, EVE, ATFB), Amsterdam, The Netherlands
| | - Didi Rhebergen
- GGZ Centraal Mental Health Care (TCF, EKJLC, DR), Amersfoort, The Netherlands; Amsterdam Public Health Research Institute, Mental Health Program (TCF, ATFB, DR), Amsterdam, The Netherlands; Department of Psychiatry (MO, AD, ATFB, DR), Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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ALHarthi SS, BinShabaib MS, Alwahibi A, Gamal S, Elashiry E, Almershed SE, Alkhamis HA, Anweigi L. Periodontal and peri-implant status and whole salivary interleukin 1-beta levels among individuals using selective serotonin reuptake inhibitors: an observational study. BMC Oral Health 2023; 23:310. [PMID: 37217913 DOI: 10.1186/s12903-023-02908-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/24/2023] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVE Selective serotonin reuptake inhibitors (SSRI) are commonly used for managing psychological diseases such as depression. These disorders are also directly associated with periodontal and peri-implant diseases, namely periodontitis and peri-implantitis, respectively. It is hypothesized that there is no difference in periodontal and peri-implant clinicoradiographic status and unstimulated whole salivary interleukin (IL)-1β levels in participants using selective serotonin reuptake inhibitors (SSRI) and controls (individuals not using SSRI). The aim of the present observational case-control study was to compare periodontal and peri-implant clinicoradiographic statuses and whole salivary IL-1β in participants using SSRI and controls. METHODS Users of SSRI and controls were included. In all participants, periodontal (plaque index [PI], gingival index [GI], probing depth [PD], clinical attachment loss [AL] and marginal bone loss [MBL]) and peri-implant (modified PI [mPI], modified GI [mGI], PD and crestal bone loss [CBL]) were assessed. Unstimulated whole saliva was collected and IL-1β levels were determined. Information related to duration of implants in function, duration of depressive symptoms and treatment of depression was retrieved from healthcare records. Sample-size was estimated using 5% error and group comparisons were performed. P < 0.05 was considered statistically significant. RESULTS Thirty-seven SSRI users and 35 controls were assessed. Individuals using SSRI had a history of depression of 4.2 ± 2.5 years. The mean age of SSRI-users and controls were 48.7 ± 5.7 and 45.3 ± 5.1 years, respectively. Tooth brushing twice daily was reported by 75.7% and 62.9% SSRI-users and controls, respectively. There was no statistically significant difference in PI, mPI, GI, mGI, PD, clinical AL, numbers of MT and mesial and distal MBL and CBL among individuals using SSRI compared with controls (Tables 3 and 4). The unstimulated whole salivary flow rate in individuals using SSRI and controls was 0.11 ± 0.003 and 0.12 ± 0.001 ml/min, respectively. Whole salivary IL-1β levels in individuals using SSRI and controls were 57.6 ± 11.6 pg/ml and 34.6 ± 5.2 pg/ml, respectively. CONCLUSION Users of SSRI and controls demonstrate healthy periodontal and peri-implant tissue statuses with no marked differences in whole salivary IL-1β levels provided oral hygiene is stringently maintained.
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Affiliation(s)
- Shatha Subhi ALHarthi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Munerah S BinShabaib
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Abdulrahman Alwahibi
- Department of Psychiatry, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Shahinaz Gamal
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Eldin Elashiry
- Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - Sarah E Almershed
- Specialist in Periodontics, Ministry of Health, Kuwait City, Kuwait
- Lecturer and Examiner at the Kuwait Board of Advanced General Dentistry, Kuwait University, Kuwait City, Kuwait
- Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait
| | | | - Lamyia Anweigi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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Dai B, Wu X, Yan F, Chen Y, Xu Y, Xia Q, Zhang X, Xie X. Effects of Modified Electroconvulsive Therapy on Serum Cortisol, Nesfatin-1, and Pro-inflammatory Cytokine Levels in Elderly Patients With Treatment-Resistant Depression. Front Endocrinol (Lausanne) 2022; 13:904005. [PMID: 35784549 PMCID: PMC9243445 DOI: 10.3389/fendo.2022.904005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
AIM Modified electroconvulsive therapy (MECT) is an effective strategy for treatment-resistant depression (TRD); however, the mechanism underlying effects of MECT remains unclear. Accumulating evidence suggests that TRD is closely associated with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, anorexigenic peptides, and pro-inflammatory cytokines. However, MECT effects on the HPA axis, anorexigenic peptides, and pro-inflammatory cytokines in elderly patients with TRD remain unclear. In this study, we investigated whether the HPA axis (cortisol), anorexigenic peptides (nesfatin-1), and pro-inflammatory cytokines (C-reactive protein, tumor necrosis factor-α, and interleukin-6, and interleukin-1β) are involved in the mechanism underlying MECT effects in elderly patients with TRD. METHODS Elderly patients with TRD were enrolled in this study between December 2019 and October 2021; all patients underwent MECT after physical examination. Serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels were measured before and after the first, third, and sixth MECT sessions. The Hamilton Depression Rating Scale-24 (HAMD-24) and the Mini-Mental State Examination (MMSE) were used to evaluate depression and cognitive impairment, respectively. We compared pre- and post-MECT serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels to confirm the short-term effects of MECT on these serum indices. We compared these serum indices across three time points (before the first, third, and sixth MECT sessions) to determine the long-term effects of MECT on serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels. RESULTS We observed no statistically significant changes in the pre- and post-MECT serum cortisol, nesfatin-1, or pro-inflammatory cytokine levels. No significant changes in serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels were observed across the aforementioned time points. Moreover, there were no statistically significant sex-based differences in the aforementioned serum indices. Furthermore, the serum cortisol level was negatively correlated with the serum IL-6 level before and after the first MECT session in patients with high cortisol levels (> the 50th percentile value of all samples). Additionally, the post-MECT HAMD-24 and MMSE scores were significantly lower. CONCLUSIONS MECT reduced depressive symptoms despite an adverse effect on cognition and had no significant effect on the serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels in elderly patients with TRD.
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Affiliation(s)
- Biao Dai
- Department of Basic and Clinical Pharmacology, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Pharmacy, Hefei Fourth People’s Hospital, Hefei, China
- Department of Medical Education and Research, Anhui Mental Health Center, Hefei, China
| | - Xiaoping Wu
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Medical Education and Research, Anhui Mental Health Center, Hefei, China
- Department of Geriatric Psychology, Hefei Fourth People’s Hospital, Hefei, China
| | - Fanfan Yan
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Medical Education and Research, Anhui Mental Health Center, Hefei, China
- Department of Geriatric Psychology, Hefei Fourth People’s Hospital, Hefei, China
| | - Yang Chen
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Medical Education and Research, Anhui Mental Health Center, Hefei, China
- Modified Electroconvulsive Therapy Room, Hefei Fourth People’s Hospital, Hefei, China
| | - Yayun Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Qingrong Xia
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Medical Education and Research, Anhui Mental Health Center, Hefei, China
- Department of Science and Education, Hefei Fourth People’s Hospital, Hefei, China
| | - Xulai Zhang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Medical Education and Research, Anhui Mental Health Center, Hefei, China
- Department of Geriatric Psychology, Hefei Fourth People’s Hospital, Hefei, China
- Anhui Provincial Clinical Research Center for Mental and Mental Diseases, Hefei, China
| | - Xuefeng Xie
- Department of Basic and Clinical Pharmacology, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China
- *Correspondence: Xuefeng Xie,
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Carlier A, Boers K, Veerhuis R, Bouckaert F, Sienaert P, Eikelenboom P, Vandenbulcke M, Stek ML, van Exel E, Dols A, Rhebergen D. S100 calcium-binding protein B in older patients with depression treated with electroconvulsive therapy. Psychoneuroendocrinology 2019; 110:104414. [PMID: 31493698 DOI: 10.1016/j.psyneuen.2019.104414] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/19/2019] [Accepted: 08/19/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Increasing evidence suggests that glial mediated disruption of neuroplasticity contributes to depression. S100 calcium-binding protein B (S100B) promotes neuronal protection in nanomolar concentrations. Studies on its possible role as a treatment outcome marker in affective disorders are limited. Recent evidence suggests a putative role for S100B as a state marker of illness activity as it is found elevated in episodes of major depression. AIM To investigate whether higher S100B is associated with favourable treatment outcome following electroconvulsive therapy (ECT) and to further explore whether S100B reflects a state marker of depression activity. METHODS Serum S100B samples, at baseline and post-ECT and clinical assessments including Montgomery Åsberg Rating scales were collected in 91 older depressed patients (mean age: 73.0 years), referred for ECT. Change in pre- and post-ECT S100B was compared between remitters and nonremitters. Logistic and Cox regression analyses were used to determine whether S100B was associated with remission of depression. RESULTS Patients with S100B levels in the intermediate tertile, that is, between 33 ng/L and 53 ng/L, had higher odds on remission, odds ratio: 5.5 (95%Confidence Interval (CI): 1.55-19.20, p = <0.01), and were more likely to remit from depression over time, hazard ratio: 1.96 (95%CI: 1.04-3.72, p = 0.04), compared with patients in the lowest tertile. There was no significant decrease in levels of S100B after ECT in both remitters and nonremitters. CONCLUSION Our findings demonstrate that patients with higher S100B levels at baseline were more likely to remit from depression suggesting an association between higher S100B and responsiveness to ECT. Next, S100B levels do not decrease after remission, suggesting S100B is not a state marker of depression. S100B is not capable of predicting treatment outcome by itself, further research may combine outcome markers.
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Affiliation(s)
- Angela Carlier
- GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute and Neuroscience Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
| | - Kimberly Boers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute and Neuroscience Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Robert Veerhuis
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute and Neuroscience Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Clinical Chemistry Department, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Filip Bouckaert
- KU Leuven, University Psychiatric Center KU Leuven, Department of Old Age Psychiatry, Leuvensesteenweg 517, 3070 Kortenberg, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Academic Center for ECT and Neuromodulation, Leuvensesteenweg 517, 3070 Kortenberg, Belgium
| | - Pascal Sienaert
- KU Leuven, University Psychiatric Center KU Leuven, Academic Center for ECT and Neuromodulation, Leuvensesteenweg 517, 3070 Kortenberg, Belgium
| | - Piet Eikelenboom
- GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the Netherlands
| | - Mathieu Vandenbulcke
- KU Leuven, University Psychiatric Center KU Leuven, Department of Old Age Psychiatry, Leuvensesteenweg 517, 3070 Kortenberg, Belgium
| | - Max L Stek
- GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute and Neuroscience Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Eric van Exel
- GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute and Neuroscience Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Annemiek Dols
- GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute and Neuroscience Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
| | - Didi Rhebergen
- GGZ inGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute and Neuroscience Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands
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Markers of HPA-axis activity and nucleic acid damage from oxidation after electroconvulsive stimulations in rats. Acta Neuropsychiatr 2019; 31:287-293. [PMID: 30854991 DOI: 10.1017/neu.2019.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Oxidative stress has been suggested to increase after electroconvulsive therapy (ECT), a treatment which continues to be the most effective for severe depression. Oxidative stress could potentially be mechanistically involved in both the therapeutic effects and side effects of ECT. METHODS We measured sensitive markers of systemic and central nervous system (CNS) oxidative stress on DNA and RNA (urinary 8-oxodG/8-oxoGuo, cerebrospinal fluid 8-oxoGuo, and brain oxoguanine glycosylase mRNA expression) in male rats subjected to electroconvulsive stimulations (ECS), an animal model of ECT. Due to the previous observations that link hypothalamic-pituitary-adrenal (HPA)-axis activity and age to DNA/RNA damage from oxidation, groups of young and middle-aged male animals were included, and markers of HPA-axis activity were measured. RESULTS ECS induced weight loss, increased corticosterone (only in middle-aged animals), and decreased cerebral glucocorticoid receptor mRNA expression, while largely leaving the markers of systemic and CNS DNA/RNA damage from oxidation unaltered. CONCLUSION These results suggest that ECS is not associated with any lasting effects on oxidative stress on nucleic acids neither in young nor middle-aged rats.
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