Cargando…

The Influence of Electroconvulsive Therapy (ECT) on Brain-Derived Neurotrophic Factor (BDNF) Plasma Level in Patients with Schizophrenia—A Systematic Review and Meta-Analysis

The main aim of this systematic review and meta-analysis is to establish whether there is a correlation between the brain-derived neurotrophic factor (BDNF) level and electroconvulsive therapy (ECT) treatment and the reduction in psychotic symptoms in patients diagnosed with schizophrenia. A systema...

Descripción completa

Detalles Bibliográficos
Autores principales: Szota, Anna Maria, Kowalewska, Beata, Ćwiklińska-Jurkowska, Małgorzata, Dróżdż, Wiktor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488522/
https://www.ncbi.nlm.nih.gov/pubmed/37685795
http://dx.doi.org/10.3390/jcm12175728
_version_ 1785103495516389376
author Szota, Anna Maria
Kowalewska, Beata
Ćwiklińska-Jurkowska, Małgorzata
Dróżdż, Wiktor
author_facet Szota, Anna Maria
Kowalewska, Beata
Ćwiklińska-Jurkowska, Małgorzata
Dróżdż, Wiktor
author_sort Szota, Anna Maria
collection PubMed
description The main aim of this systematic review and meta-analysis is to establish whether there is a correlation between the brain-derived neurotrophic factor (BDNF) level and electroconvulsive therapy (ECT) treatment and the reduction in psychotic symptoms in patients diagnosed with schizophrenia. A systematic search of PubMed/Medline, Cochrane Library, Web of Science, Scopus and Embase was conducted up to March 2023. Inclusion criteria: studies in which adult patients with schizophrenia treated with antipsychotic medication received ECT therapy and had the BDNF level measured before and after ECT treatment. Exclusion criteria: animal and in vitro studies or studies not involving complete information about the treatment and concentration of BDNF in plasma. The risk of bias was assessed using Egger’s regression-based test for meta-analysis with continuous outcomes. Six studies comprising 248 individuals with schizophrenia were included. A statistically significant increase in BDNF levels after ECT treatment was observed only in two studies (p < 0.001 and p < 0.027, respectively), whereas in four other studies, an upward trend without statistical significance was noticed. The estimated overall size effect revealed that ECT therapy caused a slight change in the BDNF level but without statistical significance (ES = −0.328). Different numbers of ECT procedures (4-10), final measurement of the BDNF level made at a different time point, using bilateral or unilateral electrode positioning during ECT and treatment with different combinations of typical or atypical antipsychotic medications may be potential reasons for the lack of statistical significance in the changes in BDNF levels after treatment. Data regarding the measurement of BDNF levels pre and post ECT therapy in patients with schizophrenia are very limited without an extended follow-up period and evaluation of mental health change. Our meta-analysis showed that treatment with ECT therapy and antipsychotic medication increases serum BDNF levels in patients with drug-resistant schizophrenia compared to patients treated with medication only; however, this effect is not statistically significant.
format Online
Article
Text
id pubmed-10488522
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-104885222023-09-09 The Influence of Electroconvulsive Therapy (ECT) on Brain-Derived Neurotrophic Factor (BDNF) Plasma Level in Patients with Schizophrenia—A Systematic Review and Meta-Analysis Szota, Anna Maria Kowalewska, Beata Ćwiklińska-Jurkowska, Małgorzata Dróżdż, Wiktor J Clin Med Systematic Review The main aim of this systematic review and meta-analysis is to establish whether there is a correlation between the brain-derived neurotrophic factor (BDNF) level and electroconvulsive therapy (ECT) treatment and the reduction in psychotic symptoms in patients diagnosed with schizophrenia. A systematic search of PubMed/Medline, Cochrane Library, Web of Science, Scopus and Embase was conducted up to March 2023. Inclusion criteria: studies in which adult patients with schizophrenia treated with antipsychotic medication received ECT therapy and had the BDNF level measured before and after ECT treatment. Exclusion criteria: animal and in vitro studies or studies not involving complete information about the treatment and concentration of BDNF in plasma. The risk of bias was assessed using Egger’s regression-based test for meta-analysis with continuous outcomes. Six studies comprising 248 individuals with schizophrenia were included. A statistically significant increase in BDNF levels after ECT treatment was observed only in two studies (p < 0.001 and p < 0.027, respectively), whereas in four other studies, an upward trend without statistical significance was noticed. The estimated overall size effect revealed that ECT therapy caused a slight change in the BDNF level but without statistical significance (ES = −0.328). Different numbers of ECT procedures (4-10), final measurement of the BDNF level made at a different time point, using bilateral or unilateral electrode positioning during ECT and treatment with different combinations of typical or atypical antipsychotic medications may be potential reasons for the lack of statistical significance in the changes in BDNF levels after treatment. Data regarding the measurement of BDNF levels pre and post ECT therapy in patients with schizophrenia are very limited without an extended follow-up period and evaluation of mental health change. Our meta-analysis showed that treatment with ECT therapy and antipsychotic medication increases serum BDNF levels in patients with drug-resistant schizophrenia compared to patients treated with medication only; however, this effect is not statistically significant. MDPI 2023-09-02 /pmc/articles/PMC10488522/ /pubmed/37685795 http://dx.doi.org/10.3390/jcm12175728 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Szota, Anna Maria
Kowalewska, Beata
Ćwiklińska-Jurkowska, Małgorzata
Dróżdż, Wiktor
The Influence of Electroconvulsive Therapy (ECT) on Brain-Derived Neurotrophic Factor (BDNF) Plasma Level in Patients with Schizophrenia—A Systematic Review and Meta-Analysis
title The Influence of Electroconvulsive Therapy (ECT) on Brain-Derived Neurotrophic Factor (BDNF) Plasma Level in Patients with Schizophrenia—A Systematic Review and Meta-Analysis
title_full The Influence of Electroconvulsive Therapy (ECT) on Brain-Derived Neurotrophic Factor (BDNF) Plasma Level in Patients with Schizophrenia—A Systematic Review and Meta-Analysis
title_fullStr The Influence of Electroconvulsive Therapy (ECT) on Brain-Derived Neurotrophic Factor (BDNF) Plasma Level in Patients with Schizophrenia—A Systematic Review and Meta-Analysis
title_full_unstemmed The Influence of Electroconvulsive Therapy (ECT) on Brain-Derived Neurotrophic Factor (BDNF) Plasma Level in Patients with Schizophrenia—A Systematic Review and Meta-Analysis
title_short The Influence of Electroconvulsive Therapy (ECT) on Brain-Derived Neurotrophic Factor (BDNF) Plasma Level in Patients with Schizophrenia—A Systematic Review and Meta-Analysis
title_sort influence of electroconvulsive therapy (ect) on brain-derived neurotrophic factor (bdnf) plasma level in patients with schizophrenia—a systematic review and meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488522/
https://www.ncbi.nlm.nih.gov/pubmed/37685795
http://dx.doi.org/10.3390/jcm12175728
work_keys_str_mv AT szotaannamaria theinfluenceofelectroconvulsivetherapyectonbrainderivedneurotrophicfactorbdnfplasmalevelinpatientswithschizophreniaasystematicreviewandmetaanalysis
AT kowalewskabeata theinfluenceofelectroconvulsivetherapyectonbrainderivedneurotrophicfactorbdnfplasmalevelinpatientswithschizophreniaasystematicreviewandmetaanalysis
AT cwiklinskajurkowskamałgorzata theinfluenceofelectroconvulsivetherapyectonbrainderivedneurotrophicfactorbdnfplasmalevelinpatientswithschizophreniaasystematicreviewandmetaanalysis
AT drozdzwiktor theinfluenceofelectroconvulsivetherapyectonbrainderivedneurotrophicfactorbdnfplasmalevelinpatientswithschizophreniaasystematicreviewandmetaanalysis
AT szotaannamaria influenceofelectroconvulsivetherapyectonbrainderivedneurotrophicfactorbdnfplasmalevelinpatientswithschizophreniaasystematicreviewandmetaanalysis
AT kowalewskabeata influenceofelectroconvulsivetherapyectonbrainderivedneurotrophicfactorbdnfplasmalevelinpatientswithschizophreniaasystematicreviewandmetaanalysis
AT cwiklinskajurkowskamałgorzata influenceofelectroconvulsivetherapyectonbrainderivedneurotrophicfactorbdnfplasmalevelinpatientswithschizophreniaasystematicreviewandmetaanalysis
AT drozdzwiktor influenceofelectroconvulsivetherapyectonbrainderivedneurotrophicfactorbdnfplasmalevelinpatientswithschizophreniaasystematicreviewandmetaanalysis