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European Archives of Psychiatry and Clinical Neuroscience

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01-04-2015 | Original Paper

Focus on ECT seizure quality: serum BDNF as a peripheral biomarker in depressed patients

Authors: Jan Malte Bumb, Suna Su Aksay, Christoph Janke, Laura Kranaster, Olga Geisel, Peter Gass, Rainer Hellweg, Alexander Sartorius

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 3/2015

Abstract

Electroconvulsive therapy (ECT) is a well-established, safe and effective treatment in severest or drug-resistant affective disorders. The potential relation between any peripheral biological marker and the seizure quality as a surrogate for treatment efficacy has not been investigated so far. We prospectively examined serum brain-derived neurotrophic factor (BDNF) levels in 20 patients with major depression before and after electroconvulsive therapy. A seizure quality sum score for every ECT session was build up on the basis of the seizure duration, seizure amplitude, central inhibition, interhemispheric coherence and sympathetic activation. Serum BDNF levels were significantly higher after ECT (P = 0.036). In the linear regression analysis, a significant correlation of the serum BDNF levels and the time between the last ECT and the blood withdrawal (P = 0.01) was observed. The ANOVA revealed a significant influence of the interval between the last ECT and the blood withdrawal (P = 0.0017) as well as the seizure quality (P = 0.038) on the variance of BDNF serum levels. Our data corroborate the neurotrophin hypothesis suggesting an ECT-induced central BDNF rise leading to a delayed (>6 days) and increased equilibrium of the peripheral BDNF. The association of seizure adequacy with a BDNF rise might underline the importance of monitoring seizure quality markers in daily practice.

Abrams R (2002) Electroconvulsive therapy, 4th edn. Oxford University Press, Oxford

Meduna L (1935) Versuche über die biologische Beeinflussung des Ablaufs der Schizophrenie. Z Ges Neural Psychiat 152:78–94

Cerletti U, Bini L (1938) Un nuevo metodo di shockterapie “L’elettroshock”. Boll Acad Med Roma 64:136–138

Nobler MS, Sackeim HA, Solomou M, Luber B, Devanand DP, Prudic J (1993) EEG manifestations during ECT: effects of electrode placement and stimulus intensity. Biol Psychiatry 34(5):321–330CrossRefPubMed

Roemer RA, Shagass C, Dubin W, Jaffe R, Katz R (1990) Relationship between pretreatment electroencephalographic coherence measures and subsequent response to electroconvulsive therapy: a preliminary study. Neuropsychobiology 24(3):121–124CrossRefPubMed

Swartz CM (1996) Disconnection of electroencephalographic, motoric, and cardiac evidence of ECT seizure. Convuls Ther 12(1):25–30PubMed

Kranaster L, Hoyer C, Janke C, Sartorius A (2013) Bispectral index monitoring and seizure quality optimization in electroconvulsive therapy. Pharmacopsychiatry 46(4):147–150. doi:10.1055/s-0032-1331748 CrossRefPubMed

Bundy BD, Hewer W, Andres FJ, Gass P, Sartorius A (2010) Influence of anesthetic drugs and concurrent psychiatric medication on seizure adequacy during electroconvulsive therapy. J Clin Psychiatry 71(6):775–777. doi:10.4088/JCP.08m04971gre CrossRefPubMed

Hoyer C, Kranaster L, Janke C, Sartorius A (2014) Impact of the anesthetic agents ketamine, etomidate, thiopental, and propofol on seizure parameters and seizure quality in electroconvulsive therapy: a retrospective study. Eur Arch Psychiatry Clin Neurosci 264(3):255–261. doi:10.1007/s00406-013-0420-5 CrossRefPubMed

10.

Aksay SS, Bumb JM, Janke C, Hoyer C, Kranaster L, Sartorius A (2014) New evidence for seizure quality improvement by hyperoxia and mild hypocapnia. J ECT. doi:10.1097/YCT.0000000000000109

11.

Wahlund B, von Rosen D (2003) ECT of major depressed patients in relation to biological and clinical variables: a brief overview. Neuropsychopharmacology 28(Suppl 1):S21–S26. doi:10.1038/sj.npp.1300135 CrossRefPubMed

12.

Merkl A, Heuser I, Bajbouj M (2009) Antidepressant electroconvulsive therapy: mechanism of action, recent advances and limitations. Exp Neurol 219(1):20–26. doi:10.1016/j.expneurol.2009.04.027 CrossRefPubMed

13.

Henn F, Vollmayr B, Sartorius A (2004) Mechanisms of depression: the role of neurogenesis. Drug Discov Today Dis Mech 1(4):407–411CrossRef

14.

Duman RS, Charney DS (1999) Cell atrophy and loss in major depression. Biol Psychiatry 45(9):1083–1084CrossRefPubMed

15.

Duman RS (2002) Synaptic plasticity and mood disorders. Mol Psychiatry 7(Suppl 1):S29–S34. doi:10.1038/sj.mp.4001016 CrossRefPubMed

16.

Karege F, Perret G, Bondolfi G, Schwald M, Bertschy G, Aubry JM (2002) Decreased serum brain-derived neurotrophic factor levels in major depressed patients. Psychiatry Res 109(2):143–148CrossRefPubMed

17.

Molendijk ML, Spinhoven P, Polak M, Bus BA, Penninx BW, Elzinga BM (2013) Serum BDNF concentrations as peripheral manifestations of depression: evidence from a systematic review and meta-analyses on 179 associations (N = 9484). Mol Psychiatry. doi:10.1038/mp.2013.105 PubMed

18.

Fernandes BS, Gama CS, Cereser KM, Yatham LN, Fries GR, Colpo G, de Lucena D, Kunz M, Gomes FA, Kapczinski F (2011) Brain-derived neurotrophic factor as a state-marker of mood episodes in bipolar disorders: a systematic review and meta-regression analysis. J Psychiatr Res 45(8):995–1004. doi:10.1016/j.jpsychires.2011.03.002 CrossRefPubMed

19.

Brunoni AR, Lopes M, Fregni F (2008) A systematic review and meta-analysis of clinical studies on major depression and BDNF levels: implications for the role of neuroplasticity in depression. Int J Neuropsychopharmacol Off Sci J Collegium Internationale Neuropsychopharmacologicum 11(8):1169–1180. doi:10.1017/S1461145708009309 CrossRef

20.

Bocchio-Chiavetto L, Zanardini R, Bortolomasi M, Abate M, Segala M, Giacopuzzi M, Riva MA, Marchina E, Pasqualetti P, Perez J, Gennarelli M (2006) Electroconvulsive Therapy (ECT) increases serum brain derived neurotrophic factor (BDNF) in drug resistant depressed patients. Eur Neuropsychopharmacol 16(8):620–624. doi:10.1016/j.euroneuro.2006.04.010 CrossRefPubMed

21.

Okamoto T, Yoshimura R, Ikenouchi-Sugita A, Hori H, Umene-Nakano W, Inoue Y, Ueda N, Nakamura J (2008) Efficacy of electroconvulsive therapy is associated with changing blood levels of homovanillic acid and brain-derived neurotrophic factor (BDNF) in refractory depressed patients: a pilot study. Prog Neuropsychopharmacol Biol Psychiatry 32(5):1185–1190. doi:10.1016/j.pnpbp.2008.02.009 CrossRefPubMed

22.

Piccinni A, Del Debbio A, Medda P, Bianchi C, Roncaglia I, Veltri A, Zanello S, Massimetti E, Origlia N, Domenici L, Marazziti D, Dell’Osso L (2009) Plasma brain-derived neurotrophic factor in treatment-resistant depressed patients receiving electroconvulsive therapy. Eur Neuropsychopharmacol 19(5):349–355. doi:10.1016/j.euroneuro.2009.01.002 CrossRefPubMed

23.

Fernandes B, Gama CS, Massuda R, Torres M, Camargo D, Kunz M, Belmonte-de-Abreu PS, Kapczinski F, de Almeida Fleck MP, Ines Lobato M (2009) Serum brain-derived neurotrophic factor (BDNF) is not associated with response to electroconvulsive therapy (ECT): a pilot study in drug resistant depressed patients. Neurosci Lett 453(3):195–198. doi:10.1016/j.neulet.2009.02.032 CrossRefPubMed

24.

Taylor SM (2008) Electroconvulsive therapy, brain-derived neurotrophic factor, and possible neurorestorative benefit of the clinical application of electroconvulsive therapy. J ECT 24(2):160–165. doi:10.1097/YCT.0b013e3181571ad0 CrossRefPubMed

25.

Association AP (2000) Diagnostic and statistical manual of mental disorders (DSM-IV-TR), text revision, 4th edn. American Psychiatric Association, Washington, DC

26.

Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62CrossRefPubMedCentralPubMed

27.

Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198CrossRefPubMed

28.

Ziegenhorn AA, Schulte-Herbruggen O, Danker-Hopfe H, Malbranc M, Hartung HD, Anders D, Lang UE, Steinhagen-Thiessen E, Schaub RT, Hellweg R (2007) Serum neurotrophins—a study on the time course and influencing factors in a large old age sample. Neurobiol Aging 28(9):1436–1445. doi:10.1016/j.neurobiolaging.2006.06.011 CrossRefPubMed

29.

Deuschle M, Gilles M, Scharnholz B, Lederbogen F, Lang UE, Hellweg R (2013) Changes of serum concentrations of brain-derived neurotrophic factor (BDNF) during treatment with venlafaxine and mirtazapine: role of medication and response to treatment. Pharmacopsychiatry 46(2):54–58. doi:10.1055/s-0032-1321908 PubMed

30.

Brunoni AR, Baeken C, Machado-Vieira R, Gattaz WF, Vanderhasselt MA (2014) BDNF blood levels after electroconvulsive therapy in patients with mood disorders: a systematic review and meta-analysis. World J Biol Psychiatry. doi:10.3109/15622975.2014.892633

31.

Gronli O, Stensland GO, Wynn R, Olstad R (2009) Neurotrophic factors in serum following ECT: a pilot study. World J Biol Psychiatry 10(4):295–301. doi:10.3109/15622970701586323 CrossRefPubMed

32.

Sartorius A, Hellweg R, Litzke J, Vogt M, Dormann C, Vollmayr B, Danker-Hopfe H, Gass P (2009) Correlations and discrepancies between serum and brain tissue levels of neurotrophins after electroconvulsive treatment in rats. Pharmacopsychiatry 42(6):270–276. doi:10.1055/s-0029-1224162 CrossRefPubMed

33.

Gass P, Riva MA (2007) CREB, neurogenesis and depression. BioEssays: news and reviews in molecular, cellular and developmental biology 29(10):957–961. doi:10.1002/bies.20658 CrossRef

34.

Inta D, Lima-Ojeda JM, Lau T, Tang W, Dormann C, Sprengel R, Schloss P, Sartorius A, Meyer-Lindenberg A, Gass P (2013) Electroconvulsive therapy induces neurogenesis in frontal rat brain areas. PLoS one 8(7):e69869. doi:10.1371/journal.pone.0069869 CrossRefPubMedCentralPubMed

35.

Pan W, Banks WA, Fasold MB, Bluth J, Kastin AJ (1998) Transport of brain-derived neurotrophic factor across the blood-brain barrier. Neuropharmacology 37(12):1553–1561CrossRefPubMed

36.

Poduslo JF, Curran GL (1996) Permeability at the blood–brain and blood–nerve barriers of the neurotrophic factors: NGF, CNTF, NT-3. Brain Res Mol Brain Research 36(2):280–286CrossRef

37.

Newton SS, Collier EF, Hunsberger J, Adams D, Terwilliger R, Selvanayagam E, Duman RS (2003) Gene profile of electroconvulsive seizures: induction of neurotrophic and angiogenic factors. J Neurosci 23(34):10841–10851PubMed

38.

Stelzhammer V, Guest PC, Rothermundt M, Sondermann C, Michael N, Schwarz E, Rahmoune H, Bahn S (2013) Electroconvulsive therapy exerts mainly acute molecular changes in serum of major depressive disorder patients. Eur Neuropsychopharmacol 23(10):1199–1207. doi:10.1016/j.euroneuro.2012.10.012 CrossRefPubMed

39.

Dale GL (1997) Platelet kinetics. Curr Opin Hematol 4(5):330–334CrossRefPubMed

40.

Lommatzsch M, Quarcoo D, Schulte-Herbruggen O, Weber H, Virchow JC, Renz H, Braun A (2005) Neurotrophins in murine viscera: a dynamic pattern from birth to adulthood. Int J Dev Neurosci 23(6):495–500. doi:10.1016/j.ijdevneu.2005.05.009 CrossRefPubMed

41.

Nockher WA, Renz H (2005) Neurotrophins in clinical diagnostics: pathophysiology and laboratory investigation. Clin Chim Acta 352(1–2):49–74. doi:10.1016/j.cccn.2004.10.002 CrossRefPubMed

Title: Focus on ECT seizure quality: serum BDNF as a peripheral biomarker in depressed patients
Authors: Jan Malte Bumb
Suna Su Aksay
Christoph Janke
Laura Kranaster
Olga Geisel
Peter Gass
Rainer Hellweg
Alexander Sartorius
Publication date: 01-04-2015
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Psychiatry and Clinical Neuroscience / Issue 3/2015
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI: https://doi.org/10.1007/s00406-014-0543-3

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Focus on ECT seizure quality: serum BDNF as a peripheral biomarker in depressed patients

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