ECS and Decreased Neuroinflammation-Implications for ECT

Out on Pubmed, from neurologists in Israel, is this pre-clinical study:

JCI Insight 2020 Aug 11;137028.

 doi: 10.1172/jci.insight.137028. Online ahead of print.

Electroconvulsive stimulation attenuates chronic neuroinflammation

Smadar Goldfarb 1, Nina Fainstein 1, Tamir Ben-Hur 1

Affiliations 

• PMID: 32780728

The abstract is copied below:

Electroconvulsive therapy is highly effective in neuropsychiatric disorders by unknown mechanisms. Microglial toxicity plays key role in neuroinflammatory and degenerative diseases, where there is critical shortage in therapies. This study examined the effects of electroconvulsive seizures (ECS) on chronic neuroinflammation and microglial neurotoxicity.Electric brain stimulation inducing full tonic-clonic seizures during chronic relapsing-progressive experimental autoimmune encephalomyelitis (EAE) reduced spinal immune cell infiltration, reduced myelin and axonal loss, and prevented clinical deterioration. Using the transfer EAE model we examined the effect of ECS on systemic immune response in donor mice versus ECS effect on CNS innate immune activity in recipient mice. ECS did not affect encephalitogenicity of systemic T cells, but targeted the CNS directly to inhibit T-cell induced neuroinflammation. In vivo and ex-vivo assays indicated that ECS suppressed microglial neurotoxicity, by reducing iNOS expression, nitric oxide and reactive oxygen species (ROS) production, and by reducing CNS oxidative stress. Microglia from ECS treated EAE mice expressed less T cell stimulatory and chemoattractant factors. Our findings indicate that Electroconvulsive therapy targets the CNS innate immune system to reduce neuroinflammation by attenuating microglial neurotoxicity. These findings signify a novel therapeutic approach for chronic neuroinflammatory, neuropsychiatric and neurodegenerative diseases.

Keywords: Inflammation; Multiple sclerosis; Neuroscience.

And from the text:

In conclusion, electroconvulsive therapy induces an immunomodulatory therapeutic effect in a clinically relevant setting of experimental chronic multiple sclerosis. CNS microglia serve as a key therapeutic target for chronic-progressive MS, and modulation of their neurotoxicity by ECT may considerably reduce their neurotoxicity. These findings may bare implications to other neurodegenerative and neuropsychiatric diseases driven by microglial neurotoxicity, such as Alzheimer’s disease (50) and major depression (55)

This is an elegant series of animal experiments, that, although targeted at multiple sclerosis, may have broader implications for understanding the mechanism of action of ECT.

The point of today's blog post is two-fold:

1) to remind us that basic science research in ECT, using ECS, continues

and

2) that the study of neuroimmunology, as it relates to ECT, is in its infancy, but promising.