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Brain Sciences
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From Bench to Bedside: Electroconvulsive Therapy on Depression
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From Bench to Bedside: Electroconvulsive Therapy on Depression

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Psychiatric Diseases".

Deadline for manuscript submissions: closed (1 July 2021) | Viewed by 15522

Special Issue Editors

Dr. Narcis Cardoner

E-Mail Website
Guest Editor
Mental Health Department, Parc Tauli University Hospital, Barcelona, Spain
Interests: Mental Disorders; Neuropsychopharmacology; Neuromodulation; Neuroimaging
Dr. Marta Cano

E-Mail Website
Guest Editor
Mental Health Department, Parc Tauli University Hospital, Barcelona, Spain
Interests: Neuroimaging; Neuromodulation; Affective Disorders

Special Issue Information

Dear Colleagues,

Although electroconvulsive therapy is one of the most effective treatments for patients with depression, its prescription is still nowadays limited to a specific subgroup of patients with a significant number of therapeutic failures. Depression affects more than 264 million people and, at its worst, close to 800.000 people die due to suicide every year, which is one person every 40 seconds. In this context, ascertaining the optimal stimulation parameters related to both clinical outcome and cognitive side-effects as well as deeply understanding its precise mode of action are important critical steps toward strengthening the scientific basis of the treatment.

 This Special Issue aims to help disentangle the use of electroconvulsive therapy on depression from a broadly translational scientific perspective. In this sense, we invite researchers to submit their original or review articles regarding all possible methodological and analytical approaches to evaluate ECT on depression, from biological preclinical models to clinical and patient’s perspective studies.

Dr. Narcis Cardoner
Dr. Marta Cano
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Electroconvulsive therapy
  • Depression
  • Side-effects
  • Residual Symptoms
  • Preclinical Models
  • Clinical Models

Published Papers (5 papers)

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Research

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17 pages, 1586 KiB  
Article
Cognitive Considerations in Major Depression: Evaluating the Effects of Pharmacotherapy and ECT on Mood and Executive Control Deficits
by Alfredo Spagna, Jason Wang, Isabella Elaine Rosario, Li Zhang, Meidan Zu, Kai Wang and Yanghua Tian
Brain Sci. 2022, 12(3), 350; https://doi.org/10.3390/brainsci12030350 - 4 Mar 2022
Cited by 3 | Viewed by 2612
Abstract
Deficits in the executive control of attention greatly impact the quality of life of patients diagnosed with major depressive disorder (MDD). However, attentional deficits are often underemphasized in clinical contexts compared with mood-based symptoms, and a comprehensive approach for specifically evaluating and treating [...] Read more.
Deficits in the executive control of attention greatly impact the quality of life of patients diagnosed with major depressive disorder (MDD). However, attentional deficits are often underemphasized in clinical contexts compared with mood-based symptoms, and a comprehensive approach for specifically evaluating and treating them has yet to be developed. The present study evaluates the efficacy of bifrontal electroconvulsive therapy (ECT) combined with drug therapy (DT) in alleviating mood-related symptomatology and executive control deficits in drug-refractory MDD patients and compares these effects with those observed in MDD patients undergoing DT only. The Hamilton Rating Scale for Depression and the Lateralized Attentional Network Test-Revised were administered across two test sessions to assess treatment-related changes in mood-based symptoms and conflict processing, respectively, in patients undergoing ECT + DT (n = 23), patients undergoing DT (n = 33), and healthy controls (n = 40). Although both groups showed an improvement in mood-based symptoms following treatment and a deficit in conflict processing estimated on error rate, a post-treatment reduction of an executive control deficit estimated on RT was solely observed in the ECT + DT patient group. Furthermore, Bayesian correlational analyses confirmed the dissociation of mood-related symptoms and of executive control measures, supporting existing literature proposing that attentional deficits and mood symptoms are independent aspects of MDD. The cognitive profile of MDD includes executive control deficits, and while both treatments improved mood-based symptoms, only ECT + DT exerted an effect on both measures of the executive control deficit. Our findings highlight the importance of considering the improvement in both mood and cognitive deficits when determining the efficacy of therapeutic approaches for MDD. Full article
(This article belongs to the Special Issue From Bench to Bedside: Electroconvulsive Therapy on Depression)
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14 pages, 1271 KiB  
Article
Features of Psychomotor Coordination in Adolescents with Neuropsychiatric Pathology Enrolled in a Standard Educational Program
by Polina Mavrenkova, Natalia Pankova, Marina Lebedeva and Mikhail Karganov
Brain Sci. 2022, 12(2), 245; https://doi.org/10.3390/brainsci12020245 - 10 Feb 2022
Viewed by 1370
Abstract
The imbalance between the speed and accuracy of cognitive-motor operations can lead to the formation of abnormal behavioral programs fraught with serious negative consequences for the individual. For successful correction and prevention of social disadaptation in adolescents with nervous and mental diseases and [...] Read more.
The imbalance between the speed and accuracy of cognitive-motor operations can lead to the formation of abnormal behavioral programs fraught with serious negative consequences for the individual. For successful correction and prevention of social disadaptation in adolescents with nervous and mental diseases and functional disorders in mental sphere in general education schools, the peculiarities of their psychomotor activity should be taken into account. We measured some parameters of visual-motor coordination and sensorimotor reaction in adolescents with mental disorders with (n = 36) or without (n = 27) organic brain damage. Adolescents from both groups showed higher speed, but poorer accuracy and smoothness, of movements than typically developing students (n = 70). The visual and acoustic reaction times were longer in adolescents with mental disorders without organic brain damage than in reference groups. Full article
(This article belongs to the Special Issue From Bench to Bedside: Electroconvulsive Therapy on Depression)
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14 pages, 340 KiB  
Article
Factors Predicting Ictal Quality in Bilateral Electroconvulsive Therapy Sessions
by Aida de Arriba-Arnau, Antonia Dalmau Llitjos, Virginia Soria, Stelania Savino, Neus Salvat-Pujol, Jordi Curto, José Manuel Menchón and Mikel Urretavizcaya
Brain Sci. 2021, 11(6), 781; https://doi.org/10.3390/brainsci11060781 - 12 Jun 2021
Cited by 4 | Viewed by 2620
Abstract
In electroconvulsive therapy (ECT), ictal characteristics predict treatment response and can be modified by changes in seizure threshold and in the ECT technique. We aimed to study the impact of ECT procedure-related variables that interact during each session and might influence the seizure [...] Read more.
In electroconvulsive therapy (ECT), ictal characteristics predict treatment response and can be modified by changes in seizure threshold and in the ECT technique. We aimed to study the impact of ECT procedure-related variables that interact during each session and might influence the seizure results. Two hundred and fifty sessions of bilateral ECT in forty-seven subjects were included. Seizure results were evaluated by two different scales of combined ictal EEG parameters (seizure quality index (SQI) and seizure adequacy markers sum (SAMS) scores) and postictal suppression rating. Repeated measurement regression analyses were performed to identify predictors of each session’s three outcome variables. Univariate models identified age, physical status, hyperventilation, basal oxygen saturation, days between sessions, benzodiazepines, lithium, and tricyclic antidepressants as predictors of seizure quality. Days elapsed between sessions, higher oxygen saturation and protocolized hyperventilation application were significant predictors of better seizure quality in both scales used in multivariate models. Additionally, lower ASA classification influenced SQI scores as well as benzodiazepine use and lithium daily doses were predictors of SAMS scores. Higher muscle relaxant doses and lower applied stimulus intensities significantly influenced the postictal suppression rating. The study found several modifiable procedural factors that impacted the obtained seizure characteristics; they could be adjusted to optimize ECT session results. Full article
(This article belongs to the Special Issue From Bench to Bedside: Electroconvulsive Therapy on Depression)

Review

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22 pages, 374 KiB  
Review
Molecular Biomarkers of Electroconvulsive Therapy Effects and Clinical Response: Understanding the Present to Shape the Future
by Elisabetta Maffioletti, Rosana Carvalho Silva, Marco Bortolomasi, Bernhard T. Baune, Massimo Gennarelli and Alessandra Minelli
Brain Sci. 2021, 11(9), 1120; https://doi.org/10.3390/brainsci11091120 - 25 Aug 2021
Cited by 12 | Viewed by 4187
Abstract
Electroconvulsive therapy (ECT) represents an effective intervention for treatment-resistant depression (TRD). One priority of this research field is the clarification of ECT response mechanisms and the identification of biomarkers predicting its outcomes. We propose an overview of the molecular studies on ECT, concerning [...] Read more.
Electroconvulsive therapy (ECT) represents an effective intervention for treatment-resistant depression (TRD). One priority of this research field is the clarification of ECT response mechanisms and the identification of biomarkers predicting its outcomes. We propose an overview of the molecular studies on ECT, concerning its course and outcome prediction, including also animal studies on electroconvulsive seizures (ECS), an experimental analogue of ECT. Most of these investigations underlie biological systems related to major depressive disorder (MDD), such as the neurotrophic and inflammatory/immune ones, indicating effects of ECT on these processes. Studies about neurotrophins, like the brain-derived neurotrophic factor (BDNF) and the vascular endothelial growth factor (VEGF), have shown evidence concerning ECT neurotrophic effects. The inflammatory/immune system has also been studied, suggesting an acute stress reaction following an ECT session. However, at the end of the treatment, ECT produces a reduction in inflammatory-associated biomarkers such as cortisol, TNF-alpha and interleukin 6. Other biological systems, including the monoaminergic and the endocrine, have been sparsely investigated. Despite some promising results, limitations exist. Most of the studies are concentrated on one or few markers and many studies are relatively old, with small sample sizes and methodological biases. Expression studies on gene transcripts and microRNAs are rare and genetic studies are sparse. To date, no conclusive evidence regarding ECT molecular markers has been reached; however, the future may be just around the corner. Full article
(This article belongs to the Special Issue From Bench to Bedside: Electroconvulsive Therapy on Depression)

Other

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14 pages, 512 KiB  
Systematic Review
The Neurobiological Basis of Cognitive Side Effects of Electroconvulsive Therapy: A Systematic Review
by Adriana Bassa, Teresa Sagués, Daniel Porta-Casteràs, Pilar Serra, Erika Martínez-Amorós, Diego J. Palao, Marta Cano and Narcís Cardoner
Brain Sci. 2021, 11(10), 1273; https://doi.org/10.3390/brainsci11101273 - 26 Sep 2021
Cited by 12 | Viewed by 3844
Abstract
Decades of research have consistently demonstrated the efficacy of electroconvulsive therapy (ECT) for the treatment of major depressive disorder (MDD), but its clinical use remains somewhat restricted because of its cognitive side effects. The aim of this systematic review is to comprehensively summarize [...] Read more.
Decades of research have consistently demonstrated the efficacy of electroconvulsive therapy (ECT) for the treatment of major depressive disorder (MDD), but its clinical use remains somewhat restricted because of its cognitive side effects. The aim of this systematic review is to comprehensively summarize current evidence assessing potential biomarkers of ECT-related cognitive side effects. Based on our systematic search of human studies indexed in PubMed, Scopus, and Web of Knowledge, a total of 29 studies evaluating patients with MDD undergoing ECT were reviewed. Molecular biomarkers studies did not consistently identify concentration changes in plasma S-100 protein, neuron-specific enolase (NSE), or Aβ peptides significantly associated with cognitive performance after ECT. Importantly, these findings suggest that ECT-related cognitive side effects cannot be explained by mechanisms of neural cell damage. Notwithstanding, S-100b protein and Aβ40 peptide concentrations, as well as brain-derived neurotrophic factor (BDNF) polymorphisms, have been suggested as potential predictive biomarkers of cognitive dysfunction after ECT. In addition, recent advances in brain imaging have allowed us to identify ECT-induced volumetric and functional changes in several brain structures closely related to memory performance such as the hippocampus. We provide a preliminary framework to further evaluate neurobiological cognitive vulnerability profiles of patients with MDD treated with ECT. Full article
(This article belongs to the Special Issue From Bench to Bedside: Electroconvulsive Therapy on Depression)
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