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No. 3 (2026)

ORIRGINAL RESEARCH

Effect of electroconvulsive therapy on the dynamics of biomarkers of blood-brain barrier permeability and brain-derived neurotrophic factor in treatment-resistant schizophrenia and depression (Preliminary analysis of research data)

https://doi.org/10.48612/psyph/7npp-5mvh-v3fx

Published 2026-10-02

  • S.N. Mosolov
    • ,
  • D.I. Malin
    • ,
  • O.V. Pavlova
    • ,
  • O.I. Gurina

S.N. Mosolov
V.P. Serbsky National Medical Research Center of Psychiatry and Narcology; Russian Medical Academy of Continuous Professional Education

D.I. Malin
V.P. Serbsky National Medical Research Center of Psychiatry and Narcology

O.V. Pavlova
V.P. Serbsky National Medical Research Center of Psychiatry and Narcology

O.I. Gurina
V.P. Serbsky National Medical Research Center of Psychiatry and Narcology

Abstract

Background. Despite the clinical effectiveness of electroconvulsive therapy (ECT) in a number of mental illnesses, the neurobiological mechanisms of the therapeutic
effect of this treatment method remain unclear and require further study.

The aim of this study was an interim analysis of the data from a study on the effect of an ECT course on the content of blood-brain barrier (BBB) permeability biomarkers in the blood serum, as well as brain-derived neurotrophic factor (BDNF) in treatment-resistant schizophrenia and depression in the first depressive episode
and recurrent depressive disorder (RDD), and to establish the relationship between these indicators and the effectiveness of therapy.

Materials and methods. The study included 45 patients with schizophrenia (N = 20) and depressive states within the framework of a first depressive episode and
recurrent depressive disorder (N = 25) according to ICD-10 criteria with resistance to psychopharmacotherapy. Before and after the course of ECT, serum titers of
antibodies to glial fibrillary acidic protein (GFAP) and neuron-specific enolase (NSE), as well as the serum concentration of brain-derived neurotrophic factor (BDNF),
were determined by enzyme-linked immunosorbent assay. Mental status was assessed using the Clinical Global Impression (CGI) scale, the Positive and Negative
Syndrome Scale (PANSS) in schizophrenia, and the 17-item Hamilton Rating Scale for Depression (HDRS-17).

Results. A positive effect of ECT with improvement of the condition was achieved in 32 of 45 patients (71.1 % of cases). Increased BBB permeability with an increase
in serum antibodies to GFAP or NSE before the start of therapy was observed in 7 patients (15.5 % of cases). In patients with schizophrenia and depressive states,
the mean titers of antibodies to GFAP and NSE before and after ECT did not differ significantly and corresponded to the control values. In non-responders, the mean
values of baseline laboratory parameters and their dynamics before and after ECT did not differ from the parameters in responders. The level of BDNF in the serum
before treatment was reduced in 41 patients, and in 4 patients (8.9 % of cases) it corresponded to the control values. The BDNF indicator during ECT in patients
with schizophrenia and depressive states did not demonstrate statistically significant differences.

Conclusion. Analysis of the study results demonstrated the effectiveness of ECT in treatment-resistant forms of paranoid schizophrenia and depressive disorders.
No effect of ECT on BBB permeability or BDNF activity was found. No relationship was established between changes in laboratory parameters during ECT and treatment effectiveness.

Keywords

electroconvulsive therapy, therapeutically resistant schizophrenia, depression, blood-brain barrier, brain-derived neurotrophic factor, anti-NSE antibodies, anti-GFAP antibodies

PDF (Русский)

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