# The Impact of Electroconvulsive Therapy on Apoptosis-Related Biomarker Gene Expression in Treatment-Resistant Depression

## TL;DR

This study shows that electroconvulsive therapy in treatment-resistant depression may reduce harmful cell death processes.

## Contribution

The study is the first to link ECT's clinical benefits with changes in apoptosis-related gene expression in TRD patients.

## Key findings

- ECT significantly reduced MADRS scores and Bax/p53 expression in TRD patients.
- Bcl-2 expression increased in TRD patients after ECT treatment.
- Changes in gene expression correlated with clinical improvement in depression symptoms.

## Abstract

Background/Objectives: The aim of this study was to simultaneously evaluate alterations in apoptosis-related biomarker gene expression accompanied by electroconvulsive therapy (ECT) in treatment-resistant depression (TRD) patients. Methods: A total of 25 subjects (15 healthy controls; 10 TRD patients) were initially tested for baseline values of relative mRNA expression of apoptosis-related markers (Bax, Bcl-2, p53, and cytochrome c) in peripheral blood samples and MADRS score. Results: Healthy subjects showed significantly lower values in MADRS, and Bax and p53, with increased Bcl-2 expression. The four-week ECT protocol (bitemporal, three sessions per week, with MADRS evaluation and blood sampling after each week) in TRD patients resulted in a concomitant significant decrease in MADRS, Bax, and p53 and an increase in Bcl-2 expression. Conclusions: Our results confirmed that the benefits observed by clinical outcome may also be attributed to the anti-apoptotic impact of ECT.