High but not low ECS stimulus intensity augments apomorphine-stimulated dopamine postsynaptic receptor functioning in rats

COMT val158met influence on electroconvulsive therapy response in major depression

There is strong evidence for a genetic contribution to the pathogenesis of depression, with the functional catechol-O-methyltransferase (COMT) val158met polymorphism having been suggested as a potential susceptibility factor. In the present study, the effect of COMT val158met on response to electroconvulsive therapy (ECT) was analyzed in a sample of 104 Caucasian patients (f = 71, m = 33) with pharmacologically treatment-resistant Major Depression. The higher active COMT 158val allele was found to be associated with (1) higher pre-ECT severity of depression and (2) better treatment response to ECT particularly regarding the core symptoms of depression as well as sleep-related symptoms. These findings were restricted to the female subgroup of patients. In summary, the present study supports a potentially gender-specific significant impact of COMT gene variation on electroconvulsive therapy response, with COMT 158val risk allele carriers suffering from more severe, pharmacologically less efficiently treatable depression and thus possibly deriving greater benefit from ECT in the first place.

Protection of dopaminergic neurons by electroconvulsive shock in an animal model of Parkinson’s disease

Electroconvulsive shock (ECS) improves motor function in Parkinson's disease. In rats, ECS stimulates the expression of various factors some of which have been proposed to exert neuroprotective actions. We have investigated the effects of ECS on 6-hydroxydopamine (6-OHDA)-injected rats. Three weeks after a unilateral administration of 6-OHDA, 85-95% nigral dopaminergic neurons are lost. Chronic ECS prevented this cell loss, protect the nigrostriatal pathway (assessed by FloroGold retrograde labeling) and reduce motor impairment in 6-OHDA-treated animals. Injection of 6-OHDA caused loss of expression of glial cell-line derived neurotrophic factor (GDNF) in the substantia nigra. Chronic ECS completely prevented this loss of GDNF expression in 6-OHDA-treated animals. We also found that protected dopaminergic neurons co-express GDNF receptor proteins. These results strongly suggest that endogenous changes in GDNF expression may participate in the neuroprotective mechanism of ECS against 6-OHDA induced toxicity.

Catechol-O-methyltransferase (COMT) polymorphisms predict treatment response in electroconvulsive therapy

Several lines of evidence suggest that catechol-O-methyltransferase (COMT) may be associated with treatment response in depression. We conducted a study on 119 patients with treatment-refractory depression admitted consecutively for electroconvulsive therapy (ECT). The COMT high/high genotype leads to a higher enzyme activity and thus lowers dopaminergic activity in the prefrontal cortex. In the present sample, those homozygous to high-active allele of COMT responded significantly more frequently to ECT.

Placebo-controlled study of rTMS for the treatment of Parkinson's disease

The objective of this study is to assess the safety and efficacy of repetitive transcranial magnetic stimulation (rTMS) for gait and bradykinesia in patients with Parkinson's disease (PD). In a double-blind placebo-controlled study, we evaluated the effects of 25 Hz rTMS in 18 PD patients. Eight rTMS sessions were performed over a 4-week period. Four cortical targets (left and right motor and dorsolateral prefrontal cortex) were stimulated in each session, with 300 pulses each, 100% of motor threshold intensity. Left motor cortex (MC) excitability was assessed using motor evoked potentials (MEPs) from the abductor pollicis brevis. During the 4 weeks, times for executing walking and complex hand movements tests gradually decreased. The therapeutic rTMS effect lasted for at least 1 month after treatment ended. Right-hand bradykinesia improvement correlated with increased MEP amplitude evoked by left MC rTMS after individual sessions, but improvement overall did not correlate with MC excitability. rTMS sessions appear to have a cumulative benefit for improving gait, as well as reducing upper limb bradykinesia in PD patients. Although short-term benefit may be due to MC excitability enhancement, the mechanism of cumulative benefit must have another explanation.

Repeated electroconvulsive stimulation impairs long-term depression in the neostriatum

BACKGROUND

Increasing and consistent findings of structural and functional abnormalities in patients with mood disorders demonstrate a clear involvement of the neostriatum. Therefore, the beneficial effect of electroconvulsive stimulation (ECS) treatment of acute state of mood disorder may relate to changes in striatal synaptic plasticity.

METHODS

We studied the effect of ECS treatment on the reported long-term depression (LTD) of synaptic excitatory afferents to striatal medium spiny neurons. Stimulation of the white matter between the cortex and the striatum elicited excitatory postsynaptic potentials (EPSPs) in medium spiny neurons in rat corticostriatal slices while recording using the whole-cell patch-clamp technique.

RESULTS

The EPSPs evoked in striatal neurons undergo LTD with repeated stimulation trains, and LTD of this pathway is impaired in rats after ECS treatment for 1 week, similar to what is reported in chronic lithium treatment. Electroconvulsive stimulation did not affect intrinsic membrane properties or the occurrence of spontaneous EPSCs. Dose-dependent inhibition of the EPSPs by a nonselective agonist of metabotropic glutamate receptor did not change in rats after ECS treatment.

CONCLUSIONS

Our data suggest that the effectiveness of electroconvulsive therapy in mood disorders may be a consequence of LTD impairment of excitatory cortical afferents to striatal projecting neurons.