No evident neuronal damage after electroconvulsive therapy

Electroconvulsive therapy (ECT) is regarded as one of the most effective tr eatments for major depressive disorder but has also been associated with co gnitive deficits possibly reflecting brain damage. The aim of this study wa s therefore to evaluate whether ECT induces cerebral damage as reflected by different biochemical measures. The concentrations in the cerebrospinal fl uid (CSF) of three established markers of neuronal/glial degeneration, tau protein (tau), neurofilament (NFL) and S-100 beta protein, were determined in nine patients who fulfilled DSM-IV criteria for major depression. CSF sa mples were collected before and after a course of six ECT sessions. The CSF /serum (S) albumin ratio reflecting potential blood-brain barrier (BBB) dys function was also determined at these time points. The treatment was clinic ally successful with a significant decline of depressive symptoms in all pa tients as assessed by the Montgomery-Asberg Rating Scale for Depression. Se veral patients had signs of BBB dysfunction and/or neuronal damage before t he start of treatment. Levels of CSF-tau, CSF-NFL and CSF-S-100 beta levels were not significantly changed by ECT. Also the CSF/S albumin ratio was fo und to be unchanged after the course of ECT. In conclusion, no biochemical evidence of neuronal/giial damage or BBB dysfunction could be demonstrated following a therapeutic course of ECT. (C) 2000 Elsevier Science Ireland Lt d. All rights reserved.