Effects of Modified Electroconvulsive Therapy on Serum Cortisol, Nesfatin-1, and Pro-inflammatory Cytokine Levels in Elderly Patients With Treatment-Resistant Depression.

Abstract

Aim:

Modified electroconvulsive therapy (MECT) is an effective strategy for treatment-resistant depression (TRD); however, the mechanism underlying effects of MECT remains unclear. Accumulating evidence suggests that TRD is closely associated with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, anorexigenic peptides, and pro-inflammatory cytokines. However, MECT effects on the HPA axis, anorexigenic peptides, and pro-inflammatory cytokines in elderly patients with TRD remain unclear. In this study, we investigated whether the HPA axis (cortisol), anorexigenic peptides (nesfatin-1), and pro-inflammatory cytokines (C-reactive protein, tumor necrosis factor-α, and interleukin-6, and interleukin-1β) are involved in the mechanism underlying MECT effects in elderly patients with TRD.

Methods:

Elderly patients with TRD were enrolled in this study between December 2019 and October 2021; all patients underwent MECT after physical examination. Serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels were measured before and after the first, third, and sixth MECT sessions. The Hamilton Depression Rating Scale-24 (HAMD-24) and the Mini-Mental State Examination (MMSE) were used to evaluate depression and cognitive impairment, respectively. We compared pre- and post-MECT serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels to confirm the short-term effects of MECT on these serum indices. We compared these serum indices across three time points (before the first, third, and sixth MECT sessions) to determine the long-term effects of MECT on serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels.

Results:

We observed no statistically significant changes in the pre- and post-MECT serum cortisol, nesfatin-1, or pro-inflammatory cytokine levels. No significant changes in serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels were observed across the aforementioned time points. Moreover, there were no statistically significant sex-based differences in the aforementioned serum indices. Furthermore, the serum cortisol level was negatively correlated with the serum IL-6 level before and after the first MECT session in patients with high cortisol levels (> the 50th percentile value of all samples). Additionally, the post-MECT HAMD-24 and MMSE scores were significantly lower.

Conclusions:

MECT reduced depressive symptoms despite an adverse effect on cognition and had no significant effect on the serum cortisol, nesfatin-1, and pro-inflammatory cytokine levels in elderly patients with TRD.

• Authors: Biao Dai, Xiaoping Wu, Fanfan Yan, Yang Chen, Yayun Xu, Qingrong Xia, Xulai Zhang, Xuefeng Xie
• Journal: Frontiers in endocrinology (Front Endocrinol (Lausanne)) Vol. 13 Pg. 904005 ( 2022) ISSN: 1664-2392 [Print] Switzerland
• PMID: 35784549 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 Dai, Wu, Yan, Chen, Xu, Xia, Zhang and Xie.

Chemical References

• Cytokines
• Interleukin-6
• NUCB2 protein, human
• Nucleobindins
• Hydrocortisone

Topics

• Aged
• Cytokines (metabolism)
• Depression
• Electroconvulsive Therapy
• Humans
• Hydrocortisone (metabolism)
• Hypothalamo-Hypophyseal System (metabolism)
• Interleukin-6
• Nucleobindins
• Pituitary-Adrenal System (metabolism)