Abstract

Electroconvulsive therapy (ECT) is an effective treatment for depression, but can have negative side effects including amnesia. The mechanisms of action underlying both the antidepressant and side effects of ECT are not well understood. An equivalent manipulation that is conducted in experimental animals is electroconvulsive seizure (ECS). Rodent studies have provided valuable insights into potential mechanisms underlying the antidepressant and side effects of ECT. However, relatively few studies have investigated the effects of ECS in animal models with a depression-relevant manipulation such as chronic stress. In the present study, mice were first exposed to chronic social stress (CSS) or a control procedure for 15 days followed by ECS or a sham procedure for 10 days. Behavioral effects were investigated using an auditory fear conditioning (learning) and expression (memory) test and a treadmill-running fatigue test. Thereafter, immunohistochemistry was conducted on brain material using the microglial marker Iba-1 and the cholinergic fibre marker ChAT. CSS did not increase fear learning and memory in the present experimental design; in both the control and CSS mice ECS reduced fear learning and fear memory expression. CSS induced the expected fatigue-like effect in the treadmill-running test; ECS induced increased fatigue in CSS and control mice. In CSS and control mice ECS induced inflammation in hippocampus in terms of increased expression of Iba-1 in radiatum of CA1 and CA3. CSS and ECS both reduced acetylcholine function in hippocampus as indicated by decreased expression of ChAT in several hippocampal sub-regions. Therefore, CSS increased fatigue and reduced hippocampal ChAT activity and, rather than reversing these effects, a repeated ECS regimen resulted in impaired fear learning-memory, increased fatigue, increased hippocampal Iba-1 expression, and decreased hippocampal ChAT expression. As such, the current model does not provide insights into the mechanism of ECT antidepressant function but does provide evidence for pathophysiological mechanisms that might contribute to important ECT side-effects.

Highlights

  • Electroconvulsive therapy (ECT) is one of the most effective therapies for major depressive disorder (MDD) [1]

  • Dose-response experiments including different electroconvulsive seizure (ECS) stimulus parameters and treatment schedules in combination with behavioral assessment of cognition would be invaluable for increasing our understanding of the relation between treatment parameters and cognitive side effects. Despite these limitations this study provides valuable insights into the cognitive side effects of ECS and mechanisms underlying these effects

  • The primary aim of this study was to establish a model of ECS reversal of depression-relevant, stress-induced behavior, thereby allowing for the study of brain changes underlying ECT in human depression

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Summary

Introduction

Electroconvulsive therapy (ECT) is one of the most effective therapies for major depressive disorder (MDD) [1]. Due to its quick onset of clinical improvement, ECT is applied for the prevention of suicide in severe depression [3]. Whilst ECT has only a few adverse effects, cognitive deficits, primarily in the form of anterograde and retrograde amnesia, are quite common and constitute a limitation on the clinical applicability of ECT [5]. These cognitive ECT side effects are typically transient, subsiding within weeks to months after discontinuation of treatment, with more severe and persistent cases of amnesia being relatively rare [5]

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