Clinical Improvement in Depression and Cognitive Deficit Following Electroconvulsive Therapy

Overview

Journal Diagnostics (Basel)

Specialty Radiology

Date 2023 May 13

PMID 37174977

Authors

Ahmad Musab Ahmad Hariza

Mohd Heikal Mohd Yunus

Jaya Kumar Murthy

Suzaily Wahab

Affiliations

Soon will be listed here.

Abstract

Electroconvulsive therapy (ECT) is a long-standing treatment choice for disorders such as depression when pharmacological treatments have failed. However, a major drawback of ECT is its cognitive side effects. While numerous studies have investigated the therapeutic effects of ECT and its mechanism, much less research has been conducted regarding the mechanism behind the cognitive side effects of ECT. As both clinical remission and cognitive deficits occur after ECT, it is possible that both may share a common mechanism. This review highlights studies related to ECT as well as those investigating the mechanism of its outcomes. The process underlying these effects may lie within BDNF and NMDA signaling. Edema in the astrocytes may also be responsible for the adverse cognitive effects and is mediated by metabotropic glutamate receptor 5 and the protein Homer1a.

References

Castillo M, Cohen A, Edberg D, Hoppensteadt D, Fareed J, Martin B . Vascular endothelial growth factor in bipolar depression: A potential biomarker for diagnosis and treatment outcome prediction. Psychiatry Res. 2020; 284:112781. DOI: 10.1016/j.psychres.2020.112781. View

Jackson J, Chugh D, Nilsson P, Wood J, Carlstrom K, Lindvall O . Altered synaptic properties during integration of adult-born hippocampal neurons following a seizure insult. PLoS One. 2012; 7(4):e35557. PMC: 3335066. DOI: 10.1371/journal.pone.0035557. View

Jiang H, Chen S, Li C, Lu N, Yue Y, Yin Y . The serum protein levels of the tPA-BDNF pathway are implicated in depression and antidepressant treatment. Transl Psychiatry. 2017; 7(4):e1079. PMC: 5416686. DOI: 10.1038/tp.2017.43. View

Malhi G, Mann J . Depression. Lancet. 2018; 392(10161):2299-2312. DOI: 10.1016/S0140-6736(18)31948-2. View

Gbyl K, Rostrup E, Raghava J, Andersen C, Rosenberg R, Larsson H . Volume of hippocampal subregions and clinical improvement following electroconvulsive therapy in patients with depression. Prog Neuropsychopharmacol Biol Psychiatry. 2020; 104:110048. DOI: 10.1016/j.pnpbp.2020.110048. View

Cano M, Martinez-Zalacain I, Bernabeu-Sanz A, Contreras-Rodriguez O, Hernandez-Ribas R, Via E . Brain volumetric and metabolic correlates of electroconvulsive therapy for treatment-resistant depression: a longitudinal neuroimaging study. Transl Psychiatry. 2017; 7(2):e1023. PMC: 5438019. DOI: 10.1038/tp.2016.267. View

Chen J, Zhao L, Liu Y, Fan S, Xie P . Comparative efficacy and acceptability of electroconvulsive therapy versus repetitive transcranial magnetic stimulation for major depression: A systematic review and multiple-treatments meta-analysis. Behav Brain Res. 2016; 320:30-36. DOI: 10.1016/j.bbr.2016.11.028. View

Lee J, Liu D, Jiang D, Kulikowicz E, Tekes A, Liu P . Fractional anisotropy from diffusion tensor imaging correlates with acute astrocyte and myelin swelling in neonatal swine models of excitotoxic and hypoxic-ischemic brain injury. J Comp Neurol. 2021; 529(10):2750-2770. PMC: 8113130. DOI: 10.1002/cne.25121. View

Alemu J, Elberling F, Azam B, Pakkenberg B, Olesen M . Electroconvulsive treatment prevents chronic restraint stress-induced atrophy of the hippocampal formation-A stereological study. Brain Behav. 2019; 9(2):e01195. PMC: 6379514. DOI: 10.1002/brb3.1195. View

10.

Joshi S, Espinoza R, Pirnia T, Shi J, Wang Y, Ayers B . Structural Plasticity of the Hippocampus and Amygdala Induced by Electroconvulsive Therapy in Major Depression. Biol Psychiatry. 2015; 79(4):282-92. PMC: 4561035. DOI: 10.1016/j.biopsych.2015.02.029. View

11.

Michinaga S, Koyama Y . Dual Roles of Astrocyte-Derived Factors in Regulation of Blood-Brain Barrier Function after Brain Damage. Int J Mol Sci. 2019; 20(3). PMC: 6387062. DOI: 10.3390/ijms20030571. View

12.

Zheng R, Zhang Y, Yang Z, Han S, Cheng J . Reduced Brain Gray Matter Volume in Patients With First-Episode Major Depressive Disorder: A Quantitative Meta-Analysis. Front Psychiatry. 2021; 12:671348. PMC: 8282212. DOI: 10.3389/fpsyt.2021.671348. View

13.

Kumar J, Hapidin H, Get Bee Y, Ismail Z . The effects of acute ethanol administration on ethanol withdrawal-induced anxiety-like syndrome in rats: A biochemical study. Alcohol. 2015; 50:9-17. DOI: 10.1016/j.alcohol.2015.10.001. View

14.

Espinoza Oyarce D, Shaw M, Alateeq K, Cherbuin N . Volumetric brain differences in clinical depression in association with anxiety: a systematic review with meta-analysis. J Psychiatry Neurosci. 2020; 45(6):406-429. PMC: 7595741. DOI: 10.1503/jpn.190156. View

15.

Alba-Ferrara L, de Erausquin G . What does anisotropy measure? Insights from increased and decreased anisotropy in selective fiber tracts in schizophrenia. Front Integr Neurosci. 2013; 7:9. PMC: 3593197. DOI: 10.3389/fnint.2013.00009. View

16.

Limoa E, Hashioka S, Miyaoka T, Tsuchie K, Arauchi R, Azis I . Electroconvulsive shock attenuated microgliosis and astrogliosis in the hippocampus and ameliorated schizophrenia-like behavior of Gunn rat. J Neuroinflammation. 2016; 13(1):230. PMC: 5009533. DOI: 10.1186/s12974-016-0688-2. View

17.

Wolff B, Raheem S, Alshawi S, Regan J, Feng L, Saligan L . Induction of fatigue-like behavior by pelvic irradiation of male mice alters cognitive behaviors and BDNF expression. PLoS One. 2020; 15(7):e0235566. PMC: 7332074. DOI: 10.1371/journal.pone.0235566. View

18.

Jing Y, Zhao N, Deng X, Feng Z, Huang G, Meng M . Pregenual or subgenual anterior cingulate cortex as potential effective region for brain stimulation of depression. Brain Behav. 2020; 10(4):e01591. PMC: 7177590. DOI: 10.1002/brb3.1591. View

19.

Rapinesi C, Kotzalidis G, Curto M, Serata D, Ferri V, Scatena P . Electroconvulsive therapy improves clinical manifestations of treatment-resistant depression without changing serum BDNF levels. Psychiatry Res. 2015; 227(2-3):171-8. DOI: 10.1016/j.psychres.2015.04.009. View

20.

Oltedal L, Bartsch H, Evjenth Sorhaug O, Kessler U, Abbott C, Dols A . The Global ECT-MRI Research Collaboration (GEMRIC): Establishing a multi-site investigation of the neural mechanisms underlying response to electroconvulsive therapy. Neuroimage Clin. 2017; 14:422-432. PMC: 5328749. DOI: 10.1016/j.nicl.2017.02.009. View