APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France.
APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France; Unité de recherche Psychiatrie-Comorbidités-Addictions - PSYCOMADD 4872 - Université Paris-Sud - AP-HP - Université Paris Saclay.
Psychiatry Res. 2021 Mar;297:113735. doi: 10.1016/j.psychres.2021.113735. Epub 2021 Jan 16.
One third of depressive patients do not achieve remission after several steps of treatment and are considered as treatment resistant. Electroconvulsive therapy (ECT) improves symptoms in 70 to 90% of such cases. Resistant depression is associated with a dysregulation of the immune system with a dysbalance between the pro- and the anti-inflammatory cytokines. Therefore, we aimed to measure the kinetic of cytokines levels before, during and at the end of ECT. To test this hypothesis, we performed a meta-analysis assessing cytokines plasma levels before, during and after ECT in patients with major depressive disorders. After a systematic database search, means and standard deviations were extracted to calculate standardized mean differences. We found that IL-6 levels increased after 1 or 2 ECT session (p = 0.01) then decrease after 4 ECT sessions (p < 0.01) with no difference at the end of ECT (p = 0.94). A small number of studies were included and there was heterogeneity across them. The present meta-analysis reveals that ECT induces an initial increase of IL-6 levels and a potential decrease of TNF-α levels. No changes on IL-4 and IL-10 levels were found. Further work is necessary to clarify the impact of ECT on peripheral cytokines.
三分之一的抑郁症患者经过多轮治疗仍未缓解，被认为是治疗抵抗。电抽搐治疗（ECT）可以改善 70%至 90%此类病例的症状。耐药性抑郁症与免疫系统失调有关，促炎细胞因子和抗炎细胞因子之间失衡。因此，我们旨在测量 ECT 前后和期间细胞因子水平的变化。为了验证这一假设，我们进行了一项荟萃分析，评估了重症抑郁症患者 ECT 前后细胞因子的血浆水平。经过系统的数据库搜索，提取平均值和标准差以计算标准化均数差异。我们发现，在 1 或 2 次 ECT 后，IL-6 水平升高（p=0.01），然后在 4 次 ECT 后下降（p<0.01），ECT 结束时无差异（p=0.94）。纳入的研究数量较少，且存在异质性。本荟萃分析显示，ECT 诱导 IL-6 水平的初始升高和 TNF-α 水平的潜在降低。未发现 IL-4 和 IL-10 水平的变化。需要进一步研究来阐明 ECT 对外周细胞因子的影响。
