The BBB in ECS and ECT: New Review From Denmark

 Out on PubMed, from investigators in Denmark, is this review:

Blood-brain barrier permeability and electroconvulsive therapy - a systematic review.

Lundsgaard CC, Gbyl K, Videbech P.Acta Neuropsychiatr. 2023 Oct 16:1-21. doi: 10.1017/neu.2023.48. Online ahead of print.PMID: 37842858 Review.

The abstract is copied below:

Objective: The cause of cognitive side-effects after electroconvulsive therapy (ECT) is largely unknown. Alterations in the blood-brain barrier (BBB) has been considered in several recent ECT studies. We therefore found it worthwhile to perform a systematic review of the literature to examine if electrically induced seizures affect the permeability of the BBB.

Methods: PubMed/MEDLINE and Embase were searched 16 November 2022. Studies with a direct measurement of BBB permeability in animals treated with modified electroconvulsive stimulation (ECS) and in humans treated with ECT were included. Synthesis of results were narrative due to the low number of studies and differences in study designs.

Results: Four animal and two human (31 participants) studies were included. In animals, two studies found increased BBB permeability to some smaller molecules after modified ECS, while the two other studies found marginally increased or unchanged permeability to albumin after treatment. In contrast, the human studies did not find increased BBB permeability to smaller molecules or albumin after ECT.

Conclusion: Animal but not human studies support increased BBB permeability to some smaller molecules after electrically induced seizures. However, this conclusion is confined by the low number of studies and the lack of studies applying state-of-the art methods. More studies using modern approaches to measuring of BBB permeability are warranted.

The article is here.
And from the text:





If American political conservatives try to "own the libs," then Danish ECT psychiatrists have certainly tried to own the blood-brain barrier. This is a very interesting article, paying homage to the Danish researcher Tom Bolwig.
The theory that ECT enhances BBB permeability is attractive, the animal data are pretty good, and the human data not yet conclusive.
Kudos to our Danish colleagues for renewing interest in this line of inquiry.

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