Department of PsychiatryTampere University HospitalTampereFinland.
Department of PsychiatrySchool of MedicineUniversity of TampereTampereFinland.
Brain Behav. 2018 Feb 22;8(4):e00933. doi: 10.1002/brb3.933. eCollection 2018 Apr.
Changes in the tumor necrosis factor-α (TNFα) have been associated with major depressive disorder (MDD). Findings concerning the effects of electroconvulsive therapy (ECT) on the TNFα level have been contradictory. The aim was to examine the immediate and long-term changes in the TNFα level and their associations with symptom reduction in patients with MDD during ECT.
The study included 30 patients with MDD. Their TNFα levels were measured at baseline and 2 and 4 hr after the first, fifth and last ECT session. Depressive symptoms were assessed with the Montgomery-Asberg Depression Rating Scale (MADRS).
The TNFα level decreased from baseline to the 2- and 4-hr measurements. There was a correlation between the first ECT session TNFα levels and the relative symptom reduction according to the MADRS score after the ECT series. Both the first (baseline) ECT and 4-hr TNFα levels were lower in responders than in nonresponders.
ECT consistently induced a decrease in the TNFα level after each studied session. A low TNFα level at the first ECT appeared to predict a symptom reduction. These findings suggest that TNFα might have a role in the pathogenesis in MDD and in the mechanism of action of ECT.
肿瘤坏死因子-α（TNFα）的变化与重度抑郁症（MDD）有关。关于电惊厥疗法（ECT）对 TNFα 水平影响的研究结果存在矛盾。本研究旨在探讨 MDD 患者在 ECT 期间 TNFα 水平的即刻和长期变化及其与症状缓解的关系。
本研究纳入了 30 例 MDD 患者。在第一次、第五次和最后一次 ECT 治疗前、后 2 小时和 4 小时测量他们的 TNFα 水平。采用蒙哥马利-阿斯伯格抑郁评定量表（MADRS）评估抑郁症状。
TNFα 水平从基线降至 2 小时和 4 小时测量值。第一次 ECT 时的 TNFα 水平与 ECT 系列后 MADRS 评分的相对症状缓解之间存在相关性。与无反应者相比，反应者在第一次 ECT（基线）和 4 小时 TNFα 水平均较低。
ECT 每次治疗后均能持续降低 TNFα 水平。第一次 ECT 时的低 TNFα 水平似乎可以预测症状的缓解。这些发现表明，TNFα 可能在 MDD 的发病机制和 ECT 的作用机制中起作用。
