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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ECT and Treatment Resistant Depression | Subjects will be those with diagnosis of major depressive disorder that have not responded to many different treatments and who are planning to take electroconvulsive therapy (ECT). This group will receive two [18F]FEPPA PET scans, one baseline and one after an average of 2.5 weeks of ECT treatments. |
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| Measure | Description | Time Frame |
|---|---|---|
| Change in translocator protein distribution volume (TSPO Vt) measured by [18F]FEPPA PET | Participants will have one [18F]FEPPA PET scan before they start ECT and a second PET scan on average after 2.5 weeks of ECT | Baseline scan and a second PET scan after an expected average time of 2.5 weeks of ECT treatment |
| Measure | Description | Time Frame |
|---|---|---|
| 17-item Hamilton Depression Rating Scale (HDRS) | Scores on the 17-item HDRS will be taken at the time of the PET scan (baseline and post-ECT) to assess whether the magnitude of change in TSPO distribution volume is associated with changes in symptom severity. | Baseline and after average 2.5 weeks of ECT treatment |
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Inclusion Criteria:
Exclusion Criteria:
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Community and tertiary care clinic
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| Name | Affiliation | Role |
|---|---|---|
| Jeffrey H Meyer, MD, PhD | Research Imaging Centre, Centre for Addiction and Mental Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre for Addiction and Mental Health | Toronto | Ontario | M5T 1R8 | Canada |
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| ID | Term |
|---|---|
| D003865 | Depressive Disorder, Major |
| ID | Term |
|---|---|
| D003866 | Depressive Disorder |
| D019964 | Mood Disorders |
| D001523 | Mental Disorders |
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Whole blood, plasma and serum samples will be kept for analysis of genotype, peripheral inflammatory markers and protein binding.
| Neurocognitive Battery |
Neurocognitive measures will be take at baseline and post-ECT to assess whether TSPO Vt is related to neurocognitive function. Neurocognitive battery includes: Autobiographical Memory Interview-Short Form (AMI-SF) Rey Auditory Verbal Learning Test (RAVLT) Wisconsin Card Sorting Test Comprehensive Trail Making Test Weschler Adult Intelligence Scale-Digit Symbol Subtest Stroop Color and Word Test Brief Visuospatial Memory Test Boston Naming Test Judgement of Line Orientation Weschler Test of Adult Reading |
| Baseline and after average 2.5 to 5 weeks of ECT treatment |
| Peripheral Inflammatory Markers | To explore whether peripheral and central inflammation are related markers of peripheral inflammation (TNF-alpha, IL-6, CRP and IL-1beta) will be measured and correlated to brain TSPO Vt. | Baseline and after average 2.5 to 5 weeks of ECT treatment |