Repetitive enhancement of serum BDNF subsequent to continuation ECT

• Published in: Acta psychiatrica Scandinavica Vol. 140; no. 5; pp. 426 - 434
• Main Authors: Vanicek, T., Kranz, G. S., Vyssoki, B., Komorowski, A., Fugger, G., Höflich, A., Micskei, Z., Milovic, S., Lanzenberger, R., Eckert, A., Kasper, S., Frey, R.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-11-2019; John Wiley and Sons Inc
• Subjects: Adult; Aged; Bipolar Disorder - blood; Bipolar Disorder - therapy; Brain-derived neurotrophic factor; Brain-Derived Neurotrophic Factor - blood; continuation electroconvulsive therapy; depression; Depressive Disorder - blood; Depressive Disorder - therapy; Electrical stimuli; Electroconvulsive Therapy; Female; Humans; Male; Middle Aged; Original; Patients; Remission; Secondary Prevention; unipolar and bipolar affective disorder; Young Adult; brain-derived neurotrophic factor; continuation electroconvulsive therapy; depression; unipolar and bipolar affective disorder
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/acps.13080

Introduction
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.
Methods
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.
Results
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.
Discussion
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.