Serum BDNF levels and the antidepressant effects of electroconvulsive therapy with ketamine anaesthesia: a preliminary study

Abstract

Objective To firstly examine the relationship between serum brain-derived neurotrophic factor (BDNF) levels and antidepressant response to ketamine as an anaesthesia in electroconvulsive therapy (ECT) in Chinese patients with treatment-refractory depression (TRD). Methods Thirty patients with TRD were enrolled and underwent eight ECT sessions with ketamine anaesthesia (0.8 mg/kg) alone. Depression severity, response and remission were evaluated using the 17-item Hamilton Depression Rating Scale (HAMD-17). Enzyme-linked immunosorbent assay (ELISA) was applied to examine serum BDNF levels in patients with TRD at baseline and after the second, fourth and eighth ECT sessions. Baseline serum samples were also collected for 30 healthy controls. Results No significant differences were observed in serum BDNF levels between patients with TRD and healthy controls at baseline (p > 0.05). The remission rate was 76.7% (23/30) after the last ECT treatment, although all patients with TRD obtained antidepressant response criteria. Serum BDNF levels were not altered compared to baseline, even between remitters and nonremitters (all p > 0.05), despite the significant reduction in HAMD-17 and Brief Psychiatric Rating Scale (BPRS) scores after ECT with ketamine anaesthesia (all p < 0.05). The antidepressant effects of ECT with ketamine anaesthesia were not correlated with changes in serum BDNF levels (all p > 0.05). Conclusion This preliminary study indicated that serum BDNF levels do not appear to be a reliable biomarker to determine the antidepressant effects of ketamine as an anaesthesia in ECT for patients with TRD. Further studies with larger sample sizes are warranted to confirm these findings.

Serum Mature BDNF Level Is Associated with Remission Following ECT in Treatment-Resistant Depression

“…Moreover, several studies have reported that patients who were remitters after receiving ECT had higher baseline levels of BDNF than non-remitters [ 11 ], suggesting that baseline BDNF levels may be more important in predicting remission than the ECT-induced modulation of BDNF [ 12 ]. However, the baseline differences between future remitters and non-remitters have not been observed in other studies [ 13 , 14 ], leaving much room for further investigation.…”

Investigating the Role of Leukocyte Telomere Length in Treatment-Resistant Depression and in Response to Electroconvulsive Therapy

“…The mechanism by which it determines an antidepressant effect is complex and not entirely clear [32]. ECT affects neurotransmission [33][34][35], induces changes in neuroendocrine [36] and neurotrophic factors [37][38][39][40], and also alters inflammatory mechanisms [41]. Some studies also showed that ECT can induce structural changes in the brain [42,43].…”