Clinical and biological predictors of response to electroconvulsive therapy (ECT): a review

Pinna, Martina; Manchia, Mirko; Oppo, Rossana; Scano, Filomena; Pillai, Gianluca; Loche, Anna Paola; Salis, Piergiorgio; Minnai, Gian Paolo

doi:10.1016/j.neulet.2016.10.047

Cited by 93 publications

(79 citation statements)

References 98 publications

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“…Given that we had opted for a naturalistic study design, besides heterogeneous in treatment, our sample was also rather heterogeneous in composition, consisting of mainly female patients, unipolar as well as bipolar patients, patients with and without melancholic symptoms and with varying degrees of suicidality. Several of these factors have been linked to ECT responsiveness in the past . However, as meta‐analyses have not found any confirmation of an influence of gender, polarity or melancholia on ECT responsiveness , we chose not to account for these factors in our analyses but do consider the heterogeneity they cause to be a limitation of our study.…”

Section: Discussionmentioning

confidence: 99%

The Maudsley Staging Method as predictor of electroconvulsive therapy effectiveness in depression

Diermen

Hebbrecht

Schrijvers

et al. 2018

Acta Psychiatr Scand

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Objective: To investigate the potential role of the Maudsley Staging Method (MSM) in the prediction of electroconvulsive therapy (ECT) outcome in severely depressed adults. Method: Between August 2015 and August 2017, 73 consecutive patients with a major depressive episode (DSM-IV-TR) scheduled for ECT were recruited. Prior to their first ECT session, the MSM was completed to assess the level of therapy resistance. To determine the reduction in depression severity and response and remission rates, symptom severity was assessed at baseline and within one week after the last ECT session using the 17-item Hamilton Depression Rating Scale (HDRS17). Results: The percentage of symptom reduction following ECT was best predicted by the MSM episode duration and depression severity factors (R 2 completer sample 0.24). Episode duration alone was the best predictor of remission (area under the ROC curve for completers: 0.72). Adding age to the models increased their predictive capacity. Conclusion: An adapted version of the MSM gauging shorter episode duration, more severe depressive symptoms and older age is significantly associated with ECT effectiveness in adults with severe recurrent depression and is thus highly suitable for use in clinical practice, promoting the shared treatment decision-making process. Significant outcomes• The percentage of HDRS decrease can be predicted by an adapted version of the MSM, evaluating baseline depression severity and episode duration.• Remission was best predicted by depressive episode duration.• Adding age to the models improved their predictive capacities. • The adapted MSM has the potential to contribute to the treatment decision-making process in patients with depression. Limitations• Although the adapted MSM is a significant predictor, it can only explain part of ECT effectiveness.• The sample size of our study is limited. • Due to our observational design, there is substantial heterogeneity in patient and treatment characteristics.

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Section: Discussionmentioning

confidence: 99%

The Maudsley Staging Method as predictor of electroconvulsive therapy effectiveness in depression

Diermen

Hebbrecht

Schrijvers

et al. 2018

Acta Psychiatr Scand

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“…Reports of associations between the changes in serum BDNF and outcome of ECT have on the whole been contradictory (Pinna et al, ). Hu et al () reported significant association between the elevation of serum BDNF level and a decreasing rate of MDD symptoms (Hu et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…In human studies, the findings on the changes in BDNF and the response to ECT are controversial (Pinna et al, 2016). Some studies have suggested that ECT increases serum or plasma BDNF levels at different time points after ECT (Bilgen et al, 2014;Bocchio-Chiavetto et al, 2006;Bumb et al, 2014;Haghighi, Salehi, et al, 2013;Hu et al, 2010;Marano et al, 2007;Okamoto et al, 2008;Piccinni et al, 2009;Salehi et al, 2016).…”

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confidence: 99%

Effect of electroconvulsive therapy on brain‐derived neurotrophic factor levels in patients with major depressive disorder

et al. 2018

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ObjectivesBrain‐derived neurotrophic factor (BDNF) has been associated with depression and its treatment response. The aim of the present study was to explore the effect of electroconvulsive therapy (ECT) on serum and plasma BDNF levels and change of Montgomery–Asberg Depression Rating Scale (MADRS) and their associations in patients with major depressive disorder (MDD).MethodsThe study included thirty patients suffering from MDD. Their serum and plasma BDNF levels were examined before ECT (baseline) and after the first, fifth, and last ECT session. The severity of the depression and the response to ECT were measured with MADRS.ResultsElectroconvulsive therapy caused no significant changes in serum BDNF levels. Plasma BDNF levels decreased during the fifth ECT session between the baseline and the 2‐hr samples (p = 0.019). No associations were found between serum or plasma BDNF levels and remission. The correlations between plasma and serum BDNF levels in each measurement varied between 0.187 and 0.636.ConclusionsNeither serum nor plasma BDNF levels were systematically associated with the clinical remission. However, the plasma BDNF levels somewhat varied during the ECT series. Therefore, the predictive value of BDNF for effects of ECT appears to be at least modest.

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“…Previously, MST has been applied to only a few patients with TRD and psychotic symptoms. Therefore, no conclusions about the effectiveness of MST in psychotic depression can be made, although this phenotype is known to respond well to ECT [30]. Also, even patients with atypical depression can benefit from ECT [31], indications for this have not yet been observed with MST [29].…”

Section: Predictors Of Responsementioning

confidence: 99%

Magnetic seizure therapy: Towards personalized seizure therapy for major depression

Kallioniemi

McClintock

Deng

et al. 2019

Personalized Medicine in Psychiatry

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Magnetic seizure therapy (MST) is a noninvasive neuromodulation therapy under investigation for the treatment of severe neuropsychiatric disorders. MST involves inducing a therapeutic seizure under anesthesia in a setting similar to electroconvulsive therapy (ECT). To date, randomized controlled trials suggest that MST has similar antidepressant efficacy as ECT, but without significant cognitive adverse effects. Large scale clinical trials are currently underway to confirm these preliminary findings. So far, there has only been one study evaluating the clinical predictors of response to MST and more research is needed. This study found that patients with fewer episodes of depression and a positive family history of depression had a better response to MST. Overall, the ability of MST to focus the delivery of the electric field and the resultant seizure makes targeting seizure therapy to specific brain regions possible, and further research will be helpful in identifying personalized targets to maximize clinical benefit. In this review, we describe MST methodology and how it could be individualized to each patient. We also summarize the clinical and cognitive effects of MST and provide indications of which patients may be most likely to benefit. Finally, we summarize the studied neurophysiological predictors of response.

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Clinical and biological predictors of response to electroconvulsive therapy (ECT): a review

Cited by 93 publications

References 98 publications

The Maudsley Staging Method as predictor of electroconvulsive therapy effectiveness in depression

The Maudsley Staging Method as predictor of electroconvulsive therapy effectiveness in depression

Effect of electroconvulsive therapy on brain‐derived neurotrophic factor levels in patients with major depressive disorder

Magnetic seizure therapy: Towards personalized seizure therapy for major depression

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