Effects of electroconvulsive therapy on neuronal and immunological parameters in patients with affective disorders

电休克治疗对情感障碍患者神经元和免疫学参数的影响

• 批准号: 389184626
• 负责人: Professor Dr. Malek Bajbouj
• 金额: --
• 依托单位: MSB Research, Development and Innovation gGmbH (MSB-RDI)
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2017
• 资助国家: 德国
• 起止时间: 2016-12-31 至 2022-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/389184626?language=en
• 关键词: Effects; electroconvulsive; therapy; neuronal; immunological

About 30% of patients suffering from major depressive disorder (MDD) do not respond sufficiently to established pharmacological, psychotherapeutic, or somatic treatment. Treatment-resistant MDD is associated with illness chronicity, a reduced quality of life, and a higher risk for suicide. For these patients, electroconvulsive therapy (ECT) is a well-established treatment strategy with response rates of 60% to 80%, making it the most potent and rapidly acting treatment for MDD. Despite the frequent and widespread use of ECT for more than 70 years, the exact neurobiological mechanisms underlying its efficacy remain unclear. In a broader sense, understanding the therapeutic effects of ECT may also shed some more light on the pathophysiological causes of severe depression and the mechanisms of action of an effective treatment. Eventually, the elucidation of the effects of ECT could allow for their reproduction in a less invasive way and with a more benign side-effect profile, thereby resulting in an significantly enhanced treatment of MDD. To achieve this, though, we need first to understand better how ECT influences brain function. The proposed project therefore aims to investigate markers of neural activity and connectivity, neurochemistry and inflammation underlying treatment response and remission after ECT. These measures will be assessed in depressive patients prior, during and after ECT and also after 6 months. Furthermore, we will investigate a control group of depressive patients treated with antidepressants. This treatment- specific approach will enable us to disentangle which behavioral, neuronal and immunological alterations are crucial for an antidepressant response and might be used for response prediction. More generally, the project will greatly broaden our understanding of the mechanisms underlying the profound antidepressant effect of ECT and thereby shed some more light on the pathophysiological causes of MDD and the mechanisms of action of an effective treatment.

约30%的重度抑郁症（MDD）患者对已建立的药物、心理治疗或躯体治疗反应不充分。难治性MDD与疾病慢性化、生活质量下降和自杀风险较高相关。对于这些患者，电休克治疗（ECT）是一种成熟的治疗策略，有效率为60%至80%，使其成为MDD最有效和快速起效的治疗方法。尽管ECT的频繁和广泛使用超过70年，其疗效背后的确切神经生物学机制仍不清楚。从更广泛的意义上说，了解ECT的治疗效果也可能揭示严重抑郁症的病理生理原因和有效治疗的作用机制。最终，阐明ECT的作用可以允许它们以侵入性较小的方式复制，并且具有更良性的副作用特征，从而导致显著增强MDD的治疗。然而，为了实现这一目标，我们首先需要更好地了解ECT如何影响大脑功能。因此，拟议的项目旨在研究ECT后神经活动和连接，神经化学和炎症的标记物，这些标记物是治疗反应和缓解的基础。这些措施将在ECT之前，期间和之后以及6个月后在抑郁症患者中进行评估。此外，我们将调查一个对照组的抑郁症患者与抗抑郁药治疗。这种治疗特异性方法将使我们能够解开哪些行为、神经元和免疫学改变对抗抑郁药反应至关重要，并可能用于反应预测。更一般地说，该项目将大大拓宽我们对ECT的深刻抗抑郁作用的机制的理解，从而揭示MDD的病理生理学原因和有效治疗的作用机制。