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Zhang H, Li H, Yu M, Yu M, Feng S, Tingting W, Yu Y, Zhang J, Liu K, Tan Y, Xiang B. Modified Electroconvulsive Therapy Normalizes Plasma GNA13 Following Schizophrenic Relapse. J ECT 2024:00124509-990000000-00202. [PMID: 39121017 DOI: 10.1097/yct.0000000000001050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2024]
Abstract
OBJECTIVE GNA13 is an important member of the G protein family, and its coding gene GNA13 has been identified as one of the risk genes for schizophrenia (SCZ). This study aimed to investigate the relationship between GNA13 levels and the clinical symptoms of SCZ following treatment with modified electroconvulsive therapy (MECT). METHODS This study recruited 82 SCZ patients and 86 healthy controls (HCs). Each SCZ patient received 6 sessions of MECT. The Positive and Negative Syndrome Scale (PANSS) was used to assess SCZ symptom severity. Plasma levels of GNA13 were measured by enzyme-linked immunosorbent assay. RESULTS Pretreatment, SCZ patients had a higher GNA13 level than HC (t = 8.199, P < 0.001). MECT reduced the GNA13 level significantly (t = 11.13, P < 0.001) and normalized the difference between SCZ and HC (t = 0.219, P = 0.827). After treatment, the downregulation of GNA13 (ΔGNA13) was negatively correlated with the positive symptoms score reduction rate (ΔP) (r = -0.379, P = 0.027) and positively correlated with the negative score reduction rate (ΔN) (r = 0.480, P = 0.004) in females. In both males and females, the receiver operating characteristic curve revealed that the pretreatment GNA13 level could help differentiate SCZ from HC (male: area under the curve = 0.792, P < 0.001; female: area under the curve = 0.814, P < 0.001). CONCLUSION The reduced expression of GNA13 after MECT may be related to the exhibition of both negative and positive symptoms of SCZ in female patients.
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Affiliation(s)
| | | | | | | | - Shuangshuang Feng
- From the Department of Psychiatry, Fundamental and Clinical Research on Mental Disorders Key Laboratory of Luzhou, Medical Laboratory Center, Laboratory of Neurological Diseases & Brain Function, Affiliated Hospital of Southwest Medical University, Luzhou
| | - Wang Tingting
- From the Department of Psychiatry, Fundamental and Clinical Research on Mental Disorders Key Laboratory of Luzhou, Medical Laboratory Center, Laboratory of Neurological Diseases & Brain Function, Affiliated Hospital of Southwest Medical University, Luzhou
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Schuster H, Walters RW, Mathy J, Ramaswamy S, Alsakaf I. Correlation Between ECT Quality Measures and Likelihood to Transition From Acute to Continuation and Maintenance ECT. J ECT 2024:00124509-990000000-00171. [PMID: 38924479 DOI: 10.1097/yct.0000000000001028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
OBJECTIVES To evaluate the association between 3 ECT quality measures (seizure duration, Postictal Suppression Index [PSI], and heart rate response) and therapeutic compliance as indicated by transitioning from acute to continuation to maintenance phases of ECT. METHODS This was a retrospective chart review of patients who received ECT between July 2016 and July 2019. ECT quality measures were lagged by 1 ECT session to examine the effect of the prior session's quality measure on progressing to a higher ECT phase at the subsequent ECT session. Associations with therapeutic compliance were analyzed using mixed-effects ordinal regression and mixed-effects partial proportional odds models. RESULTS Seizure duration was associated with 8% higher adjusted odds of progressing to out of the acute phase (95% confidence interval [CI]: 2% to 15%, P = 0.007) and 18% higher adjusted odds of progressing to the maintenance phase (95% CI: 10% to 28%, P < 0.001); PSI was associated with 9% higher adjusted odds of progressing out of the acute phase (95% CI: 3% to 16%, P = 0.005), whereas heart rate response was not statistically associated with therapeutic compliance. Greater therapeutic compliance was also associated with bilateral electrode placement and older age. CONCLUSIONS Longer seizure duration was associated with greater therapeutic compliance across all ECT phases, PSI was associated with progressing out of the acute phase, and heart rate response was not associated with therapeutic compliance. Our findings assist ECT psychiatrists in optimizing ECT quality measures to promote better compliance with ECT.
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Affiliation(s)
| | - Ryan W Walters
- Clinical Research and Public Health, School of Medicine, Creighton University, Omaha, NE; and
| | - Jacob Mathy
- University of South Dakota School of Medicine, Sioux Falls, SD
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Wang T, Yu M, Gu X, Liang X, Wang P, Peng W, Liu D, Chen D, Huang C, Tan Y, Liu K, Xiang B. Mechanism of electroconvulsive therapy in schizophrenia: a bioinformatics analysis study of RNA-seq data. Psychiatr Genet 2024; 34:54-60. [PMID: 38441120 DOI: 10.1097/ypg.0000000000000362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVE The molecular mechanism of electroconvulsive therapy (ECT) for schizophrenia remains unclear. The aim of this study was to uncover the underlying biological mechanisms of ECT in the treatment of schizophrenia using a transcriptional dataset. METHODS The peripheral blood mRNA sequencing data of eight patients (before and after ECT) and eight healthy controls were analyzed by integrated co-expression network analysis and the differentially expressed genes were analyzed by cluster analysis. Gene set overlap analysis was performed using the hypergeometric distribution of phypfunction in R. Associations of these gene sets with psychiatric disorders were explored. Tissue-specific enrichment analysis, gene ontology enrichment analysis, and protein-protein interaction enrichment analysis were used for gene set organization localization and pathway analysis. RESULTS We found the genes of the green-yellow module were significantly associated with the effect of ECT treatment and the common gene variants of schizophrenia ( P = 0.0061; family-wise error correction). The genes of the green-yellow module are mainly enriched in brain tissue and mainly involved in the pathways of neurotrophin, mitogen-activated protein kinase and long-term potentiation. CONCLUSION Genes associated with the efficacy of ECT were predominantly enriched in neurotrophin, mitogen-activated protein kinase and long-term potentiation signaling pathways.
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Affiliation(s)
| | - Minglan Yu
- Medical Laboratory Center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province
| | - Xiaochu Gu
- Clinical Laboratory, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu Province
| | | | | | | | - Dongmei Liu
- Department of Psychiatry, Yibin Fourth People's Hospital, Yibin
| | - Dechao Chen
- Department of Psychiatry, Yibin Fourth People's Hospital, Yibin
| | | | - Youguo Tan
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan Province, China
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Peng W, Tan Q, Yu M, Wang P, Wang T, Yuan J, Liu D, Chen D, Huang C, Tan Y, Liu K, Xiang B, Liang X. Transcriptome Sequencing Reveals the Potential Mechanisms of Modified Electroconvulsive Therapy in Schizophrenia. Psychiatry Investig 2021; 18:385-391. [PMID: 33910328 PMCID: PMC8169330 DOI: 10.30773/pi.2020.0410] [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: 11/24/2020] [Accepted: 03/13/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Schizophrenia (SCZ) is one of the most common and severe mental disorders. Modified electroconvulsive therapy (MECT) is the most effective therapy for all kinds of SCZ, and the underlying molecular mechanism remains unclear. This study is aim to detect the molecule mechanism by constructing the transcriptome dataset from SCZ patients treated with MECT and health controls (HCs). METHODS Transcriptome sequencing was performed on blood samples of 8 SCZ (BECT: before MECT; AECT: after MECT) and 8 HCs, weighted gene co-expression network analysis (WGCNA) was used to cluster the different expression genes, enrichment and protein-protein interaction (PPI) enrichment analysis were used to detect the related pathways. RESULTS Three gene modules (black, blue and turquoise) were significantly associated with MECT, enrichment analysis found that the long-term potentiation pathway was associated with MECT. PPI enrichment p-value of black, blue, turquoise module are 0.00127, <1×10-16 and 1.09×10-13, respectively. At the same time, EP300 is a key node in the PPI for genes in black module, which got from the transcriptome sequencing data. CONCLUSION It is suggested that the long-term potentiation pathways were associated with biological mechanism of MECT.
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Affiliation(s)
- Wanhong Peng
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qingyu Tan
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Minglan Yu
- Medical Laboratory Center, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Ping Wang
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Tingting Wang
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, China.,Zigong Mental Health Research Center, Zigong Mental Health Center, Zigong, China
| | - Jixiang Yuan
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Dongmei Liu
- Department of Psychiatry, Yibin Fourth People's Hospital, Yibin, China
| | - Dechao Chen
- Department of Psychiatry, Yibin Fourth People's Hospital, Yibin, China
| | - Chaohua Huang
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Youguo Tan
- Zigong Mental Health Center, Zigong, China
| | - Kezhi Liu
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Bo Xiang
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, China.,Zigong Mental Health Research Center, Zigong Mental Health Center, Zigong, China
| | - Xuemei Liang
- Department of Psychiatry, Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Affiliated Hospital of Southwest Medical University, Luzhou, China
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Maruyama S, Boku S, Okazaki S, Kikuyama H, Mizoguchi Y, Monji A, Otsuka I, Sora I, Kanazawa T, Hishimoto A, Yoneda H. ATP and repetitive electric stimulation increases leukemia inhibitory factor expression in astrocytes: A potential role for astrocytes in the action mechanism of electroconvulsive therapy. Psychiatry Clin Neurosci 2020; 74:311-317. [PMID: 32022358 DOI: 10.1111/pcn.12986] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 01/23/2020] [Accepted: 01/28/2020] [Indexed: 12/26/2022]
Abstract
AIM Electroconvulsive therapy (ECT) is effective for psychiatric disorders. However, its action mechanism remains unclear. We previously reported that transcription factor 7 (TCF7) was increased in patients successfully treated with ECT. TCF7 regulates Wnt pathway, which regulates adult hippocampal neurogenesis. Adult hippocampal neurogenesis is involved in the pathophysiology of psychiatric disorders. Astrocytes play a role in adult hippocampal neurogenesis via neurogenic factors. Of astrocyte-derived neurogenic factors, leukemia inhibitory factor (LIF) and fibroblast growth factor 2 (FGF2) activate Wnt pathway. In addition, adenosine triphosphate (ATP), released from excited neurons, activates astrocytes. Therefore, we hypothesized that ECT might increase LIF and/or FGF2 in astrocytes. To test this, we investigated the effects of ATP and electric stimulation (ES) on LIF and FGF2 expressions in astrocytes. METHODS Astrocytes were derived from neonatal mouse forebrain and administered ATP and ES. The mRNA expression was estimated with quantitative reverse-transcription polymerase chain reaction. Protein concentration was measured with ELISA. RESULTS ATP increased LIF, but not FGF2, expression. Multiple ES, but not single, increased LIF expression. Knockdown of P2X2 receptor (P2X2R) attenuated ATP-induced increase of LIF mRNA expression. In contrast, P2X3 and P2X4 receptors intensified it. CONCLUSION P2X2R may mediate ATP-induced LIF expression in astrocytes and multiple ES directly increases LIF expression in astrocytes. Therefore, both ATP/P2X2R and multiple ES-induced increases of LIF expression in astrocytes might mediate the efficacy of ECT on psychiatric disorders. Elucidating detailed mechanisms of ATP/P2X2R and multiple ES-induced LIF expression is expected to result in the identification of new therapeutic targets for psychiatric disorders.
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Affiliation(s)
| | - Shuken Boku
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoshi Okazaki
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroki Kikuyama
- Department of Psychiatry, Osaka Medical College, Takatsuki, Japan
| | - Yoshito Mizoguchi
- Department of Psychiatry, Saga University Faculty of Medicine, Saga, Japan
| | - Akira Monji
- Department of Psychiatry, Saga University Faculty of Medicine, Saga, Japan
| | - Ikuo Otsuka
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ichiro Sora
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tetsufumi Kanazawa
- Department of Psychiatry, Osaka Medical College, Takatsuki, Japan.,Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Akitoyo Hishimoto
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Yoneda
- Department of Psychiatry, Osaka Medical College, Takatsuki, Japan
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Singh A, Kar SK. How Electroconvulsive Therapy Works?: Understanding the Neurobiological Mechanisms. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2017; 15:210-221. [PMID: 28783929 PMCID: PMC5565084 DOI: 10.9758/cpn.2017.15.3.210] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 12/06/2016] [Accepted: 12/21/2016] [Indexed: 12/29/2022]
Abstract
Electroconvulsive therapy (ECT) is a time tested treatment modality for the management of various psychiatric disorders. There have been a lot of modifications in the techniques of delivering ECT over decades. Despite lots of criticisms encountered, ECT has still been used commonly in clinical practice due to its safety and efficacy. Research evidences found multiple neuro-biological mechanisms for the therapeutic effect of ECT. ECT brings about various neuro-physiological as well as neuro-chemical changes in the macro- and micro-environment of the brain. Diverse changes involving expression of genes, functional connectivity, neurochemicals, permeability of blood-brain-barrier, alteration in immune system has been suggested to be responsible for the therapeutic effects of ECT. This article reviews different neurobiological mechanisms responsible for the therapeutic efficacy of ECT.
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Affiliation(s)
- Amit Singh
- Department of Psychiatry, King George's Medical University, Lucknow, U.P, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, U.P, India
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