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Electroconvulsive therapy improves hematological inflammatory markers in bipolar disorder

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Abstract

Background

Immune dysfunction and inflammation participate in the pathophysiology of bipolar disorder (BD). Abnormal levels of inflammatory markers, namely, red cell distribution width (RDW) and platelet distribution width (PDW), were detected in BD. Electroconvulsive therapy (ECT) for various mental disorders including BD was linked to changes in these inflammatory mediators. Hence, we aimed to assess the impact of ECT on PDW and RDW in patients with BD.

Methods

Seventy-two patients aged ≥ 16 were enrolled in the current prospective cohort study over 6 months, diagnosed as BD based on DSM-IV and indicated for ECT and complete blood count (CBC) drawn pre-ECT and after four ECT sessions.

Results

By the end of the ECT sessions, we noticed a significant elevation in PDW with lowering in RDW levels. However, no significant differences were detected before and after ECT regarding platelet (PLTs) count, mean platelet volume (MPV), and Plateletcrit (PCT).

Conclusion

ECT seems to improve the CBC-derived inflammatory markers (RDW and PDW) subsequently, improving the underlying inflammatory process in BD without disturbing PLT homeostasis which support its anti-inflammatory role in BD.

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Data availability

All data analyzed and generated during this study are included in this published article.

Abbreviations

BD :

Bipolar disorder

CNS :

Central nervous system

CBC :

Complete blood count

DSM-IV :

Diagnostic and statistical manual of mental disorders—fourth edition

ECG :

Electrocardiogram

ECT :

Electroconvulsive therapy

MPV :

Mean platelet volume

NLR :

Neutrophil-to-lymphocyte ratio

PCT :

Plateletcrit

PLTs :

Platelets

PDW :

Platelet distribution width

PLR :

Platelet-to-lymphocyte ratio

RBC :

Red blood cell

RDW :

Red cell distribution width

SCID-I :

Structured clinical interview for DSM-IV axis I disorders

UD :

Unipolar depression

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Authors and Affiliations

  1. Psychiatry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Eman Ali

  2. Clinical Hematology Unit, Internal Medicine Department, Faculty of Medicine, Zagazig University, Al-Sharika, Zagazig, 44519, Egypt

    Ahmed Embaby

  3. Psychiatry Department, Faculty of Medicine, Al Azhar University for Girls, Cairo, Egypt

    Shaymaa M. Arafa & Doaa Ibrahim

  4. Anatomy Department, Faculty of Medicine, Al Azhar University for Men, Cairo, Egypt

    Ahmed Kamal Elbana

  5. Basic Medical Sciences Department, Sulaiman AlRajhi University, Al Bukayriyah, Saudi Arabia

    Ahmed Kamal Elbana

  6. Clinical Sciences Department, Sulaiman AlRajhi University, Al Bukayriyah, Saudi Arabia

    Mohamed Ghazala

Authors
  1. Eman Ali
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  2. Ahmed Embaby
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  3. Shaymaa M. Arafa
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  4. Ahmed Kamal Elbana
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  5. Mohamed Ghazala
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  6. Doaa Ibrahim
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Contributions

AE and EA: conceptualization, methodology, statistical analysis, interpreting the results, designed the figures, investigation, performed patients’ clinical assessment and follow-up as well as drafted this manuscript with help from DI, MG, and SMA. AE and AKE are involved in planning, organization, supervision and reviewing of the work, and the final manuscript. All authors have read and approved the manuscript.

Corresponding author

Correspondence to Ahmed Embaby.

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Ali, E., Embaby, A., Arafa, S.M. et al. Electroconvulsive therapy improves hematological inflammatory markers in bipolar disorder. Psychopharmacology 241, 351–357 (2024). https://doi.org/10.1007/s00213-023-06491-8

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