Neurofilament light chain as a marker of neuronal damage remains stable during a course of electroconvulsive therapy

Introduction:

Electroconvulsive therapy (ECT) is a highly effective treatment for severe depressive and psychotic disorders. Side effects comprise transient cognitive deficits and headache. Mainly due to the cognitive deficits, there are still some reservations regarding ECT as it might cause brain damage. However, several earlier studies using different methods failed to find evidence for such structural brain damage following ECT.

Neurofilament light chain (NfL) is part of the neural cytoskeleton and has proven to be a sensitive biomarker in neurodegenerative diseases and even sports-related subconcussive impacts. As NfL can be easily measured from peripheral blood, it may serve as a suitable marker for potential brain damage in the course of an ECT treatment.

Methods:

In a preliminary sample of 13 patients with major depressive disorder, NfL levels were measured before (1), one day after (2), and one week (3) after the course of ECT using an ultrasensitive single molecule array (Simoa) technology. Montgomery-Åsberg Depression Rating Scale and Mini-Mental State Examination were used for clinical assessment.

Results:

Although NfL measures 2 and 3 were performed during the anticipated climax of cognitive deficits, NfL levels were remarkably stable and we could not observe a rise of NfL when compared to baseline. NfL levels were significantly correlated with age but not with MADRS and MMSE measures.

Conclusion:

Thus, there is still no evidence that ECT might cause structural brain damage even when using a new and very sensitive methodology.