title: Raised plasma levels of tumor necrosis factor alpha in patients with depression: normalization during electroconvulsive therapy.
abstract: OBJECTIVE
  To examine whether electroconvulsive therapy (ECT) could modulate tumor necrosis factor (TNF)alpha levels in patients with depressive disorders.
  
  
  METHODS
  Plasma levels of TNFalpha were analyzed in 23 depressed patients, mainly with severe depressive disorders, and in 15 sex- and age-matched healthy controls. Fifteen depressed patients were followed longitudinally with measurement of TNFalpha before, during, and after repeated ECT treatment. For comparison, TNFalpha levels were also analyzed longitudinally in the 8 depressed patients not receiving ECT.
  
  
  RESULTS
  Patients with depressive disorders had markedly raised TNFalpha levels compared with healthy controls. The clinical improvement during repeated ECT was accompanied by a gradual and significant decline in TNFalpha level, reaching levels comparable with those in healthy controls at the end of the study. Such a decline was not seen in the depressed patients not receiving ECT, who instead showed raised TNFalpha levels throughout the study period.
  
  
  CONCLUSIONS
  Our findings support an association between inflammation and TNFalpha in particular and severe depression, and suggest that ECT may down-regulate this immune activation.
authors.affiliation: NTNU-Norwegian University of Science and Technology, Department of Psychology, N-7440 Trondheim, Norway. khestad@online.no
authors.forename: Knut A
authors.initials: KA
authors.lastname: Hestad
authors.forename: Sverre
authors.initials: S
authors.lastname: Tønseth
authors.forename: Charlotte D
authors.initials: CD
authors.lastname: Støen
authors.forename: Thor
authors.initials: T
authors.lastname: Ueland
authors.forename: Pål
authors.initials: P
authors.lastname: Aukrust
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000276:immunology / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D015415:Biomarkers; D014409:Tumor Necrosis Factor-alpha