Electroconvulsive therapy in treatment of resistant schizophrenia: biological markers of efficacy and safety

Close metadata

Recommended articles:

Ginkgolide B: mechanisms of neurobiological effects, prospects for use in the therapy of Alzheimer’s disease. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;(4):22-27

Long-term follow-up of adult patients with serial and status course of epileptic seizures. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;(4):63-68

Associations of serum neuromarkers with clinical features of Parkinson’s disease. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;(4):145-152

Cognitive impairment in patients with arterial hypertension. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;(4-2):41-48

The association of single-nucleotide polymorphism rs6265 of the brain-derived neurotrophic factor gene with clinical features in Parkinson’s disease. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;(7):82-88

Short-term outcomes of mechanical and hand-sewn laparoscopic one-anastomosis mini-gastric bypass. Pirogov Russian Journal of Surgery. 2024;(4):29-37

Colorectal cancer and gut microbiota. P.A. Herzen Journal of Oncology. 2024;(2):60-66

Development of professional activities of healthy lifestyle specialists without medical education. Russian Journal of Preventive Medicine. 2024;(4):116-123

Possibilities of physiotherapy in glaucomatous optic neuropathy after glaucoma surgery. Russian Annals of Ophthalmology. 2024;(3):88-94

Effectiveness of spinal traction in degenerative spine diseases. (A literature review). Problems of Balneology, Physiotherapy and Exercise Therapy. 2024;(4):60-69

Objective. To evaluate clinical and biological efficacy and safety of electroconvulsive therapy (ECT) in patients with treatment-resistant paranoid schizophrenia. Material and methods. Determination of CNS specific biological markers (BDNF, NSE, S100B), together with markers of inflammation and CNS alteration (IL-2, CPK, CPK-MB), and clinical evaluation were performed in two groups of patients: the ECT + antipsychotic treatment group (n=66) and the antipsychotic treatment group (n=32). Results and conclusion. In the ECT + antipsychotic treatment group, the more pronounced reduction of psychotic symptoms has been revealed compared with subjects on antipsychotic treatment as monotherapy. Patients receiving ECT showed no increase in plasma levels of inflammation and CNS alteration biomarkers (NSE, S100B, CPK, CPK-MB, IL-2). The plasma level of BDNF, capable to characterize both the efficacy and safety of antipsychotic therapy, had a more pronounced upward trend in subjects with combined electroconvulsive and antipsychotic treatment, which may indicate good tolerability and high effectiveness of ECT.

Keywords:

ECT

antipsychotic treatment

efficacy

safety

biological markers

BDNF

NSE

S100B

CPK

CPK-MB

IL-2

neuroprotection

neurodegeneration

inflammation

Authors:

Ivanov M.V.

FGBU "Sankt-Peterburgskiĭ nauchno-issledovatel'skiĭ psikhonevrologicheskiĭ institut im. V.M. Bekhtereva", Sankt-Peterburg

Zubov D.S.

Bekhterev National Medical Research Center of Psychiatry and Neurology, St.-Petersburg, Russia

List of references:

Wittchen HU, Jacobi F, Rehm J, Svensson GAM, Jönsson B, Olesen J, Allgulander C, Alonso J, Faravelli C, Fratiglioni L, Jennum P, Lieb R, Maercker A, van Os J, Preisig M, Salvador-Carulla L, Simon R, Steinhausen H-C. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011;21(9):655-79. https://doi.org/10.1016/j.euroneuro.2011.07.018
Altamura C, Fagiolini A, Galderisi S, Rocca P, Rossi A. Schizophrenia today: epidemiology, diagnosis, course and models of care. Journal of Psychopathology. 2014;20:223-243.
Kane JM, Marder SR. Psychopharmacologic treatment of schizophrenia. Schizophr Bull. 1993;19:287-230. https://doi.org/10.1093/schbul/19.2.287
Conley RR, Buchanan RW. Evaluation of treatment-resistant schizophrenia. Schizophr Bull. 1997;23(4):663-674. https://doi.org/10.1093/schbul/23.4.663
Mosolov SN. Rezistentnost’ k psikhofarmakoterapii i metody ee preodoleniya. Psikhiatriya i Psikhofarmakoterapiya. 2002;4(4):132-136. (In Russ.)
Solanki RK, Singh P, Munshi D. Current perspectives in the treatment of resistant schizophrenia. Indian J Psychiatry. 2009;51(4):254-260. https://doi.org/10.4103/0019-5545.58289
Zervas IM, Theleritis C, Soldatos CR. Using ECT in schizophrenia: a review from a clinical perspective. World J Biol Psychiatry. 2012;13(2):96-105. https://doi.org/10.3109/15622975.2011.564653
Miyamoto S, Jarskog LF, Fleischhacker WW. Schizophrenia: when clozapine fails. Curr Opin Psychiatry. 2015;28(3):243-248. https://doi.org/10.1097/yco.0000000000000159
Kane J, Honigfeld G, Singer J, Meltzer H., the Clozaril Collaborative Study Group. Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine. Arch Gen Psychiatry. 1988;45:789-796. https://doi.org/10.1001/archpsyc.1988.01800330013001
Meltzer HY. Duration of a clozapine trial in neuroleptic-resistant schizophrenia. Arch Gen Psychiatry. 1989;46:672. https://doi.org/10.1001/archpsyc.1989.01810070098017
Rosenheck R, Cramer J, Xu W, Thomas J, Henderson W, Frisman L, Fye C, Charney D. A comparison of clozapine and haloperidol in hospitalized patients with refractory schizophrenia. Department of Veterans Affairs Cooperative Study Group on Clozapine in Refractory Schizophrenia. N Engl J Med. 1997;337:809-815. https://doi.org/10.1056/nejm199709183371202
Englisch S, Zink M. Treatment-resistant Schizophrenia: Evidence-based Strategies. Mens Sana Monogr. 2012;10(1):20-32. https://doi.org/10.4103/0973-1229.91588
Mossaheb N, Kaufmann RM. Role of aripiprazole in treatment-resistant schizophrenia. Neuropsychiatr Dis Treat. 2012;8:235-244. https://doi.org/10.2147/ndt.s13830
Dold M, Leucht S. Pharmacotherapy of treatment-resistant schizophrenia: a clinical perspective. Evid Based Ment Health. 2014;17(2):33-37. https://doi.org/10.1136/eb-2014-101813
Siskind DJ, Lee M, Ravindran A, Zhang Q, Ma E, Motamarri B, Kisely S. Augmentation strategies for clozapine refractory schizophrenia: A systematic review and meta-analysis. Aust N Z J Psychiatry. 2018;1:4867418772351. https://doi.org/10.1177/0004867418772351
Combination and High-Dose Atypical Antipsychotic Therapy in Patients with Schizophrenia: Systematic Review. CADTH Technol Overv. 2012;2(3).
Ortiz-Orendain J, Castiello-de Obeso S, Colunga-Lozano LE, Hu Y, Maayan N, Adams C. Antipsychotic combinations for schizophrenia. The Cochrane Database of Systematic Reviews. 2017. https://doi.org/10.1002/14651858.cd009005.pub2
Fink M, Taylor MA. Electroconvulsive Therapy Evidence and Challenge. JAMA. 2007;298(3):330-332. https://doi.org/10.1001/jama.298.3.330
Greenhalgh J, Knight C, Hind D Beverley C, Walters S. Clinical and cost-effectiveness of electroconvulsive therapy for depressive illness, schizophrenia, catatonia and mania: systematic reviews and economic modelling studies. Health Technol Assess. 2005;9(9):1-156. https://doi.org/10.3310/hta9090
Dabrowski M, Parnowski T. Clinical analysis of safety and effectiveness of electroconvulsive therapy. Psychiatr Pol. 2012;46(3):345-360.
Shimizu E, Hashimoto K, Watanabe H, Okamura N, Koike K, Komatsu N, Kumakiri C, Nakazato M, Shinoda N, Sin-ichi Okada, Masaomi Iyo. Alterations of serum levels of brain-derived neurotrophic factor (BDNF) in depressed patients with or without antidepressants. Biol Psychiatry. 2003;54(1):70-75. https://doi.org/10.1016/s0006-3223(03)00181-1
Li J, Ye F, Xiao W, Tang X, Sha W, Zhang X, Wang J. Increased serum brain-derived neurotrophic factor levels following electroconvulsive therapy or antipsychotic treatment in patients with schizophrenia. Eur Psychiatry. 2016;36:23-28. https://doi.org/10.1016/j.eurpsy.2016.03.005
Yamamori H, Hashimoto R, Ishima T, Kishi F, Yasuda Y, Ohi K, Fujimoto M, Umeda-Yano S, Ito A, Hashimoto K, Takeda M. Plasma levels of mature brain-derived neurotrophic factor (BDNF) and matrix metalloproteinase-9 (MMP-9) in treatment-resistant schizophrenia treated with clozapine. Neurosci Lett. 2013;27;556:37-41. https://doi.org/10.1016/j.neulet.2013.09.059
Bilgen AE, Bozkurt ZS, Zincir S, Özdemir B, Ak M, Aydemir E, Şener I. Effects of electroconvulsive therapy on serum levels of brain-derived neurotrophic factor and nerve growth factor in treatment resistant major depression. Brain Res Bull. 2014;104:82-87. https://doi.org/10.1016/j.brainresbull.2014.04.005
McFarquhar TF, Thompson J. Knowledge and attitudes regarding electroconvulsive therapy among medical students and the general public. The Journal of ECT. 2008;24 (4):244-253. https://doi.org/10.1097/yct.0b013e318168be4a
Golenkov AV. Otnoshenie raznykh grupp naseleniya k elektrosudorozhnoi terapii. [Elektronnyi resurs]. Meditsinskaya psikhologiya v Rossii: elektron. nauch. zhurn. 2011;5. Data obrashcheniya: 02.07.18. URL: http://medpsy.ru (In Russ.)
Baghai TC, Möller H-J. Electroconvulsive therapy and its different indications. Dialogues Clin Neurosci. 2008;10(1):105-117.
Watts BV, Groft A, Bagian JP, Mills PD. An examination of mortality and other adverse events related to electroconvulsive therapy using a national adverse event report system. JECT. 2011;27(2):105-108. https://doi.org/10.1097/yct.0b013e3181f6d17f
Andrade C, Arumugham SS, Thirthalli J. Adverse Effects of Electroconvulsive Therapy. Psychiatr Clin North Am. 2016;39(3):513-530. https://doi.org/10.1016/j.psc.2016.04.004
Payne N, Prudic J. Electroconvulsive Therapy Part I: A Perspective on the Evolution and Current Practice of ECT. J Psychiatr Pract. 2009;15(5):346-368. https://doi.org/10.1097/01.pra.0000361277.65468.ef
Hergenroeder GW, Redell JB, Moore AN, Dash PK. Biomarkers in the clinical diagnosis and management of traumatic brain injury. Mol Diagn Ther. 2008;12(6):345-358. https://doi.org/10.1007/bf03256301
Mrozek S, Dumurgier J, Citerio G, Mebazaa A, Geeraerts T. Biomarkers and acute brain injuries: interest and limits. Crit Care. 2014;18(2):220. Published online 2014 Apr 24. https://doi.org/10.1186/cc13841
Battista AP, Buonora JE, Rhind SG, Buonora JE, Yarnell AM, Lazarus RC, Mousseau M, Latour LL, Rizoli SB, Baker AJ, Rhind SG, Diaz-Arrastia R, Mueller GP. Multivariate analysis of traumatic brain injury: development of an assessment score. Front Neurol. 2015;6:68. https://doi.org/10.3389/fneur.2015.00068
Miller BJ, Buckley P, Seabolt W, Mellor A, Kirkpatrick B. Meta-analysis of cytokine alterations in schizophrenia: clinical status and antipsychotic effects. Biol Psychiatry. 2011;70(7):663-671. https://doi.org/10.1016/j.biopsych.2011.04.013
Annya MS, Stephen M. The Neuroimmunology of Schizophrenia. Biol Psychiatry. 2013;70(7):663-671. https://doi.org/10.9758/cpn.2013.11.3.107
Lehman AF, Lieberman JA, Dixon LB, McGlashan TH, Miller AL, Perkins DO, Kreyenbuhl J. American Psychiatric Association; Steering Committee on Practice Guidelines. Practice guideline for the treatment of patients with schizophrenia, second edition. Am J Psychiatry. 2004;161(2 suppl):1-56.
Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin. 1987;13(2):261-276.
Lingjaerde O, Ahlfors UG, Bech P, Dencker SJ, Elgen K.The UKU side effect rating scale. A new comprehensive rating scale for psychotropic drugs and a cross-sectional study of side effects in neuroleptic-treated patients. Acta Psychiatr Scand Suppl. 1987;334:1-100.

Close metadata