Inflammation and Electroconvulsive Therapy

Does Electroconvulsive Therapy Cause Neuroinflammation? An [18F]FEPPA Positron Emission Tomography Study in Treatment Resistant Depression

The purpose of this study is to explore whether electroconvulsive therapy (ECT) accidentally leads to a side effect of brain inflammation. Patients with treatment resistant depression who are planning to take ECT will be subsequently approached to participate in the study.

The first scan will take place before the first ECT session. The second scan will occur after a minimum of six ECT sessions (average 2.5 weeks). Secondary measures will include mood symptom severity, neurocognitive measures, peripheral inflammatory markers and TSPO genotype.

The hypothesis is that neuroinflammation will be increased by ECT.

There will be no alterations to standard care of depressed patients due to participation in the study.

Inclusion Criteria:

• stable physical health
• diagnosis of non-psychotic, non-catatonic, major depressive disorder, either unipolar or bipolar and a non-response to at least three clinical trials at appropriate dose of antidepressant medication from at least three different pharmacological classes
• at least a 17 on the17-item HDRS despite taking antidepressant treatment prior to ECT
• have not received ECT within the last 12 weeks

Exclusion Criteria:

• currently pregnant
• current substance abuse or dependence
• neurological or unstable medical illness
• use of anti-inflammatory drugs within the past month
• diazepam or other benzodiazepine use within the past month, except for lorazepam and clonazepam