Exploration of New Molecular Mechanisms for Antidepressant Actions of Electroconvulsive Seizure

Abstract

Electroconvulsive seizure (ECS) therapy is a clinically proven treatment for depression and is often effective even in patients resistant to chemical antidepressants. However, the molecular mechanisms underlying the therapeutic efficacy of ECS are not fully understood. Here, I review studies that show molecular, cellular, and behavioral changes by ECS treatment, and discuss the functions of ECS to underlie the action of antidepressant effects. In hippocampus, these changes cover gene induction, increased adult neurogenesis, and electrophysiological reactivity. Especially, the role of vascular endothelial growth factor (VEGF) in neurogenesis is discussed. Among other gene expression changes in hippocampus, a role of cyclooxygenase (COX)-2, an inducible type of the rate-limiting enzyme of prostanoid synthesis, is focused. ECS-induced changes in other brain regions such as prefrontal cortex and hypothalamus, and ECS-induced behavioral changes are also reviewed. Understanding the molecular, cellular, and behavioral changes by ECS will provide a new view to find potential targets for novel antidepressant design that are highlighted by these findings.

The influence of inflammatory cytokines in physiopathology of suicidal behavior

“…In addition, there are animal studies showing that VEGF could mediate the effect of electroconvulsive seizures (Warner-Schmidt and Duman, 2008;Segi-Nishida, 2011;Elfving and Wegener, 2012). These effects are believed to be mediated via the main brain receptor for VEGF action, the flk-1 receptor (Kiuchi et al, 2012;Isung et al, 2012).…”

The Dynamic Brain: Neuroplasticity and Mental Health

“…Factors that have been associated with increased neurogenesis include environmental enrichment, exercise, learning, electroconvulsive shock, and chronic administration of antidepressants and other psychotropic medications. 15,18,21,24,[29][30][31][32][33][34] Reactive neurogenesis (increases after injury) has also been reported, which may be a confounding variable in some animal studies. 3,15 Chronic stress, depression, and illness have been associated with suppressed neurogenesis.…”

Autism-Like Behavior in BTBR Mice Is Improved by Electroconvulsive Therapy

“…Mechanisms underlying the therapeutic effects of ECT remain largely elusive, with 2 major hypotheses dominating: the anticonvulsant, whereby the effects are attributed to the increase of seizure threshold and decrease of seizure duration observed during the course of ECT [35], and the neurotrophic, which brings in the induction of several neurotrophic factors (e.g., brain-derived neurotrophic factor, vascular endothelial growth factor), transcription factors (e.g., cfos), and neurogenesis as explanations [36,37].…”