The ratio and interaction between neurotrophin and immune signaling during electroconvulsive therapy in late-life depression
Background: Electroconvulsive therapy (ECT) is the most effective treatment for severe late-life depression (LLD), and several hypotheses on the precise working mechanism have been proposed. Preclinical evidence suggests that ECT induces changes in neurotrophin and inflammatory signaling and that th...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | Brain, Behavior, & Immunity - Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666354621001927 |
| _version_ | 1819174618033815552 |
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| author | Dore Loef Kristof Vansteelandt Mardien L. Oudega Philip van Eijndhoven Angela Carlier Eric van Exel Didi Rhebergen Pascal Sienaert Mathieu Vandenbulcke Filip Bouckaert Annemiek Dols |
| author_facet | Dore Loef Kristof Vansteelandt Mardien L. Oudega Philip van Eijndhoven Angela Carlier Eric van Exel Didi Rhebergen Pascal Sienaert Mathieu Vandenbulcke Filip Bouckaert Annemiek Dols |
| author_sort | Dore Loef |
| collection | DOAJ |
| description | Background: Electroconvulsive therapy (ECT) is the most effective treatment for severe late-life depression (LLD), and several hypotheses on the precise working mechanism have been proposed. Preclinical evidence suggests that ECT induces changes in neurotrophin and inflammatory signaling and that these neurotrophic and inflammatory systems affect each other. We examine the relation, interaction, and ratio between the neurotrophic brain-derived neurotrophic factor (BDNF) and the proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α), and depression severity during ECT. Methods: In this naturalistic longitudinal study, linear mixed models were used to analyze the relation between BDNF, IL-6, TNF-α, and depression severity (determined by the Montgomery-Åsberg Depression Rating Scale; MADRS) in 99 patients with severe LLD before ECT (T0), three weeks after the first ECT (T1), and one week after the last ECT (T2). Results: No significant association was found between BDNF, IL-6 and TNF-α, and MADRS scores at any time point. However, a significant interaction between TNF-α and BDNF in relation to MADRS was established (p = .020) at all time points. With higher levels of TNF-α, the relation between BDNF and MADRS becomes more negative. Furthermore, a higher ratio of TNF-α/BDNF was associated with a higher score on the MADRS (p = .007). Conclusion: A possible explanation for the absence of a significant coevolution between the proinflammatory cytokines and BDNF could be that the study design was unable to determine parameters shortly after ECT sessions. However, the TNF-α/BDNF ratio was positively associated with depression severity, and the association of BDNF-level and depression severity depended on the level of TNF-α. This suggests that the interaction and balance between neurotrophin and immune signaling, specifically BDNF and TNF-α, could be relevant in LLD. This could be a focus in future research regarding treatment and the working mechanism of ECT. |
| first_indexed | 2024-12-22T20:41:50Z |
| format | Article |
| id | doaj.art-6417081e3724470eb6ea325840db9d92 |
| institution | Directory Open Access Journal |
| issn | 2666-3546 |
| language | English |
| last_indexed | 2024-12-22T20:41:50Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain, Behavior, & Immunity - Health |
| spelling | doaj.art-6417081e3724470eb6ea325840db9d922022-12-21T18:13:19ZengElsevierBrain, Behavior, & Immunity - Health2666-35462021-12-0118100389The ratio and interaction between neurotrophin and immune signaling during electroconvulsive therapy in late-life depressionDore Loef0Kristof Vansteelandt1Mardien L. Oudega2Philip van Eijndhoven3Angela Carlier4Eric van Exel5Didi Rhebergen6Pascal Sienaert7Mathieu Vandenbulcke8Filip Bouckaert9Annemiek Dols10Amsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, De Boelelaan 1117, 1118, 1081 HV, Amsterdam, the Netherlands; GGZ InGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the Netherlands; Corresponding author. Dore Loef | GGZ inGeest, Oldenaller 1, office H2.011081 HJ, Amsterdam, the Netherlands.University Psychiatric Center KU Leuven, Academic Center for ECT and Neuromodulation AcCENT, Leuvensesteenweg 517, 3070, Kortenberg, BelgiumAmsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, De Boelelaan 1117, 1118, 1081 HV, Amsterdam, the Netherlands; GGZ InGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the NetherlandsDonders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Kapittelweg 29, 6525 EN, Nijmegen, the NetherlandsAmsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, De Boelelaan 1117, 1118, 1081 HV, Amsterdam, the Netherlands; GGZ InGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the Netherlands; Pro Persona Mental Health Institute, Department of Old Age Psychiatry, Nijmeegsebaan 61, 6525 DX, Nijmegen, the NetherlandsAmsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, De Boelelaan 1117, 1118, 1081 HV, Amsterdam, the Netherlands; GGZ InGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the NetherlandsAmsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, De Boelelaan 1117, 1118, 1081 HV, Amsterdam, the Netherlands; GGZ InGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the Netherlands; Mental Health Care Institute GGZ Centraal, Westsingel 41, 3811 BB, Amersfoort, the NetherlandsUniversity Psychiatric Center KU Leuven, Academic Center for ECT and Neuromodulation AcCENT, Leuvensesteenweg 517, 3070, Kortenberg, BelgiumUniversity Psychiatric Center KU Leuven, Department of Old Age Psychiatry, Leuven/Kortenberg, BelgiumUniversity Psychiatric Center KU Leuven, Academic Center for ECT and Neuromodulation AcCENT, Leuvensesteenweg 517, 3070, Kortenberg, Belgium; University Psychiatric Center KU Leuven, Department of Old Age Psychiatry, Leuven/Kortenberg, BelgiumAmsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, De Boelelaan 1117, 1118, 1081 HV, Amsterdam, the Netherlands; GGZ InGeest Specialized Mental Health Care, Department of Old Age Psychiatry, Oldenaller 1, 1081 HJ, Amsterdam, the NetherlandsBackground: Electroconvulsive therapy (ECT) is the most effective treatment for severe late-life depression (LLD), and several hypotheses on the precise working mechanism have been proposed. Preclinical evidence suggests that ECT induces changes in neurotrophin and inflammatory signaling and that these neurotrophic and inflammatory systems affect each other. We examine the relation, interaction, and ratio between the neurotrophic brain-derived neurotrophic factor (BDNF) and the proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α), and depression severity during ECT. Methods: In this naturalistic longitudinal study, linear mixed models were used to analyze the relation between BDNF, IL-6, TNF-α, and depression severity (determined by the Montgomery-Åsberg Depression Rating Scale; MADRS) in 99 patients with severe LLD before ECT (T0), three weeks after the first ECT (T1), and one week after the last ECT (T2). Results: No significant association was found between BDNF, IL-6 and TNF-α, and MADRS scores at any time point. However, a significant interaction between TNF-α and BDNF in relation to MADRS was established (p = .020) at all time points. With higher levels of TNF-α, the relation between BDNF and MADRS becomes more negative. Furthermore, a higher ratio of TNF-α/BDNF was associated with a higher score on the MADRS (p = .007). Conclusion: A possible explanation for the absence of a significant coevolution between the proinflammatory cytokines and BDNF could be that the study design was unable to determine parameters shortly after ECT sessions. However, the TNF-α/BDNF ratio was positively associated with depression severity, and the association of BDNF-level and depression severity depended on the level of TNF-α. This suggests that the interaction and balance between neurotrophin and immune signaling, specifically BDNF and TNF-α, could be relevant in LLD. This could be a focus in future research regarding treatment and the working mechanism of ECT.http://www.sciencedirect.com/science/article/pii/S2666354621001927Electroconvulsive therapy (ECT)DepressionBrain-derived neurotrophic factor (BDNF)Interleukin-6 (IL-6)Tumor necrosis factor α (TNF-α) |
| spellingShingle | Dore Loef Kristof Vansteelandt Mardien L. Oudega Philip van Eijndhoven Angela Carlier Eric van Exel Didi Rhebergen Pascal Sienaert Mathieu Vandenbulcke Filip Bouckaert Annemiek Dols The ratio and interaction between neurotrophin and immune signaling during electroconvulsive therapy in late-life depression Brain, Behavior, & Immunity - Health Electroconvulsive therapy (ECT) Depression Brain-derived neurotrophic factor (BDNF) Interleukin-6 (IL-6) Tumor necrosis factor α (TNF-α) |
| title | The ratio and interaction between neurotrophin and immune signaling during electroconvulsive therapy in late-life depression |
| title_full | The ratio and interaction between neurotrophin and immune signaling during electroconvulsive therapy in late-life depression |
| title_fullStr | The ratio and interaction between neurotrophin and immune signaling during electroconvulsive therapy in late-life depression |
| title_full_unstemmed | The ratio and interaction between neurotrophin and immune signaling during electroconvulsive therapy in late-life depression |
| title_short | The ratio and interaction between neurotrophin and immune signaling during electroconvulsive therapy in late-life depression |
| title_sort | ratio and interaction between neurotrophin and immune signaling during electroconvulsive therapy in late life depression |
| topic | Electroconvulsive therapy (ECT) Depression Brain-derived neurotrophic factor (BDNF) Interleukin-6 (IL-6) Tumor necrosis factor α (TNF-α) |
| url | http://www.sciencedirect.com/science/article/pii/S2666354621001927 |
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