Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
Acta Psychiatr Scand. 2019 Nov;140(5):426-434. doi: 10.1111/acps.13080. Epub 2019 Sep 11.
Continuation electroconvulsive therapy (c-ECT) is highly effective for the prevention of depressive symptom relapse. There is a lack of understanding, about how c-ECT works in humans, particularly with regard to its effects on brain derived neurotrophic factor (BDNF) concentrations. Here, we aimed to close a gap in the literature by evaluating BDNF levels in patients receiving c-ECT.
We included 13 patients with either unipolar or bipolar depression (mean age ± SD: 55.5 ± 17.1; f/m: 10/3; unipolar/bipolar: 10/3) who received between one and four c-ECT (average per patient: 2.8). Serum BDNF (sBDNF) levels were assessed before and after each c-ECT sessions. Clinical assessments were also administered both before and after treatment.
Our analysis revealed a significant increase in sBDNF after each treatment (c-ECT 1-3: P < 0.001, c-ECT 4: P = 0.018). The application of multiple c-ECT treatments was not, however, associated with further sBDNF enhancements. Psychometric scores were not significantly altered following c-ECT.
An increase in sBDNF concentrations subsequent to c-ECT parallel data from the animal literature, which has linked regularly applied electrical stimulation to neuroplastic processes. This finding suggests a relationship between ECT-induced sBDNF concentrations and (sustained) remission status, considering a stable clinical condition across c-ECT.
继续电抽搐治疗(c-ECT)在预防抑郁症状复发方面非常有效。目前对于 c-ECT 如何在人体中发挥作用,特别是其对脑源性神经营养因子(BDNF)浓度的影响,人们的理解还很有限。在这里,我们旨在通过评估接受 c-ECT 的患者的 BDNF 水平来填补文献中的空白。
我们纳入了 13 名患有单相或双相抑郁症的患者(平均年龄 ± 标准差:55.5 ± 17.1;f/m:10/3;单相/双相:10/3),他们接受了 1 到 4 次 c-ECT(每位患者平均:2.8 次)。在每次 c-ECT 前后评估血清 BDNF(sBDNF)水平。在治疗前后还进行了临床评估。
我们的分析显示,每次治疗后 sBDNF 水平均显著升高(c-ECT 1-3:P<0.001,c-ECT 4:P=0.018)。然而,多次 c-ECT 治疗并不会进一步增加 sBDNF。c-ECT 后心理测量评分没有显著改变。
c-ECT 后 sBDNF 浓度的增加与动物文献中的数据相平行,该文献将定期应用电刺激与神经可塑性过程联系起来。考虑到 c-ECT 期间的稳定临床状况,这一发现表明 ECT 诱导的 sBDNF 浓度与(持续)缓解状态之间存在关系。