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The novel seizure quality index for the antidepressant outcome prediction in electroconvulsive therapy: association with biomarkers in the cerebrospinal fluid

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Abstract

For patients with depression treated with electroconvulsive therapy (ECT), the novel seizure quality index (SQI) can predict the risk of non-response (and non-remission)—as early as after the second ECT session—based the extent of several ictal parameters of the seizure. We aim to test several CSF markers on their ability to predict the degree of seizure quality, measured by the SQI to identify possible factors, that could explain some variability of the seizure quality. Baseline CSF levels of metabolites from the kynurenine pathway, markers of neurodegeneration (tau proteins, β-amyloids and neurogranin), elements of the innate immune system, endocannabinoids, sphingolipids, neurotrophic factors (VEGF) and Klotho were measured before ECT in patients with depression (n = 12) to identify possible correlations with the SQI by Pearson's partial correlation. Negative, linear relationships with the SQI for response were observed for CSF levels of T-tau (rpartial = − 0.69, p = 0.019), phosphatidylcholines (rpartial = − 0.52, p = 0.038) and IL-8 (rpartial = − 0.67, p = 0.047). Regarding the SQI for remission, a negative, linear relationship was noted with CSF levels of the endocannabinoid AEA (rpartial = − 0.70, p = 0.024) and CD163 (rpartial = − 0.68, p = 0.029). In sum, CSF Markers for the innate immune system, for neurodegeneration and from lipids were found to be associated with the SQI for response and remission after adjusting for age. Consistently, higher CSF levels of the markers were always associated with lower seizure quality. Based on these results, further research regarding the mechanism of seizure quality in ECT is suggested.

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Acknowledgements

LK received support by the German Research Foundation (DFG-Grant no. KR 4689/3-1).

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany

    Laura Kranaster & Alexander Sartorius

  2. Department of Neurology, University Medical Centre Mannheim, Mannheim, Germany

    Carolin Hoyer

  3. Institute for Clinical Chemistry, University Medical Centre Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, Mannheim, Germany

    Sonani Mindt & Michael Neumaier

  4. Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Munich, Germany

    Norbert Müller & Peter Zill

  5. Marion Von Tessin Memory-Zentrum, München, Germany

    Norbert Müller

  6. Institute of Laboratory Medicine, University Hospital LMU Munich, Munich, Germany

    Markus J. Schwarz & Natalie Moll

  7. Institute for Physiological Chemistry, University Medical Center Mainz of the Johannes Gutenberg University, Mainz, Germany

    Beat Lutz & Laura Bindila

  8. Department of Neurology, National TSE (Transmissible Spongiform Encephalopathies) Reference Centre, University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany

    Inga Zerr & Matthias Schmitz

  9. Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden

    Kaj Blennow & Henrik Zetterberg

  10. Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden

    Kaj Blennow & Henrik Zetterberg

  11. Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK

    Henrik Zetterberg

  12. UK Dementia Research Institute at UCL, London, UK

    Henrik Zetterberg

  13. Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany

    Dieter Haffner & Maren Leifheit-Nestler

  14. Randall Centre for Cell and Molecular Biophysics, King’s College London, London, UK

    Cagakan Ozbalci

  15. Heidelberg University Biochemistry Center, Heidelberg, Germany

    Cagakan Ozbalci

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  1. Laura Kranaster
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  2. Carolin Hoyer
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Correspondence to Laura Kranaster.

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Kranaster, L., Hoyer, C., Mindt, S. et al. The novel seizure quality index for the antidepressant outcome prediction in electroconvulsive therapy: association with biomarkers in the cerebrospinal fluid. Eur Arch Psychiatry Clin Neurosci 270, 911–919 (2020). https://doi.org/10.1007/s00406-019-01086-x

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