SERUM NEURON-SPECIFIC ENOLASE LEVELS DO NOT INCREASE AFTER ELECTROCONVULSIVE-THERAPY

Background: Cognitive disorders occurring after electroconvulsive ther apy (ECT) are regarded as an expression of brain damage, despite compu ted tomography (CT) and magnetic resonance imaging (MRI) showing no si gns of structural brain damage. Serum neuron-specific enolase (NSE) is a sensitive marker of neuronal damage (i.e., after stroke or cardiac arrest). The objective of this study was to investigate whether ECT le ads to a rise in the serum NSE level as an expression of neuronal dama ge. Methods: We investigated seven patients (four women, three men; me an age 6212 years) with major depressive disorder, who were treated wi th ECT for the first time. ECT was administered every 2 days, three ti mes a week under standard conditions (anaesthesia: thiopental, succiny lcholine, 100% oxygen, unilateral ECT, seizure duration more than 20 s ). Blood samples were drawn at the following times. For the first ECT: 15 and 1 min before ECT, and 1, 5, 10, 15, 20, 25, 30, 45, 60, 75, 90 , 105, 120 min, and 8, 12, 24 h after ECT. For all subsequent ECT: 1 m in before and 4 h after every ECT. Serum NSE was measured by means of enzyme immunoassay (Cobas Core NSE, EIA, Hoffmann-La Roche). Results: On average, each patient underwent ECT 10 times (range 5-20). In the f irst ECT there was no difference in serum NSE levels before and at all times following ECT. A comparison of serum NSE levels before and afte r each subsequent bout of ECT revealed no differences. Moreover, compa ring the baseline serum NSE levels (before the first ECT) with the val ues after final ECT showed no differences either. Conclusion: ECT did not increase serum NSE values, indicating that electroconvulsive thera py does not cause neuronal damage. (C) 1997 Elsevier Science B.V.