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Abstract
Electroconvulsive therapy (ECT) is regarded as one of the most effective treatments
for major depressive disorder but has also been associated with cognitive deficits
possibly reflecting brain damage. The aim of this study was therefore to evaluate
whether ECT induces cerebral damage as reflected by different biochemical measures.
The concentrations in the cerebrospinal fluid (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 samples were collected before and after a course of six ECT sessions.
The CSF/serum (S) albumin ratio reflecting potential blood-brain barrier (BBB) dysfunction
was also determined at these time points. The treatment was clinically successful
with a significant decline of depressive symptoms in all patients as assessed by the
Montgomery-Asberg Rating Scale for Depression. Several patients had signs of BBB dysfunction
and/or neuronal damage before the 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 found to be unchanged after the course of ECT. In conclusion, no biochemical
evidence of neuronal/glial damage or BBB dysfunction could be demonstrated following
a therapeutic course of ECT.