title: The role of APOE-ɛ4 and beta amyloid in the differential rate of recovery from ECT: a review.
abstract: Individual biological differences may contribute to the variability of outcomes, including cognitive effects, observed following electroconvulsive treatment (ECT). A narrative review of the research literature on carriage of the apolipoprotein E ɛ4 allele (APOE-ɛ4) and the protein biomarker beta amyloid (Aβ) with ECT cognitive outcome was undertaken. ECT induces repeated brain seizures and there is debate as to whether this causes brain injury and long-term cognitive disruption. The majority of ECT is administered to the elderly (over age 65 years) with drug-resistant depression. Depression in the elderly may be a symptom of the prodromal stage of Alzheimer's disease (AD). Carriage of the APOE-ɛ4 allele and raised cerebral Aβ are consistently implicated in AD, but inconsistently implicated in brain injury (and related syndromes) recovery rates. A paucity of brain-related recovery, genetic and biomarker research in ECT responses in the elderly was found: three studies have examined the effect of APOE-ɛ4 allele carriage on cognition in the depressed elderly receiving ECT, and two have examined Aβ changes after ECT, with contradictory findings. Cognitive changes in all studies of ECT effects were measured by a variety of psychological tests, making comparisons of such changes between studies problematic. Further, psychological test data-validity measures were not routinely administered, counter to current testing recommendations. The methodological issues of the currently available literature as well as the need for well-designed, hypothesis driven, longitudinal studies are discussed.
authors.affiliation: School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia.
authors.forename: T A
authors.initials: TA
authors.lastname: Sutton
authors.affiliation: 1] School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia [2] Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia [3] Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Centre, Nedlands, WA, Australia.
authors.forename: H R
authors.initials: HR
authors.lastname: Sohrabi
authors.affiliation: 1] Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia [2] Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Centre, Nedlands, WA, Australia.
authors.forename: S R
authors.initials: SR
authors.lastname: Rainey-Smith
authors.affiliation: 1] School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia [2] Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia [3] Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Centre, Nedlands, WA, Australia.
authors.forename: S M
authors.initials: SM
authors.lastname: Bird
authors.affiliation: 1] Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia [2] Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Centre, Nedlands, WA, Australia [3] School of Psychology, University of Western Australia, Hollywood Private Hospital, Nedlands, WA, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Weinborn
authors.affiliation: 1] School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia [2] Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia [3] Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Centre, Nedlands, WA, Australia.
authors.forename: R N
authors.initials: RN
authors.lastname: Martins
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016229:Amyloid beta-Peptides / Q000235:genetics* / Q000378:metabolism; D000818:Animals; D053327:Apolipoprotein E4 / Q000235:genetics* / Q000378:metabolism; D001921:Brain / Q000378:metabolism; D003866:Depressive Disorder / Q000235:genetics* / Q000378:metabolism / Q000628:therapy*; D004565:Electroconvulsive Therapy; D005260:Female; D005819:Genetic Markers / Q000235:genetics; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests
chemical_list: D016229:Amyloid beta-Peptides; D053327:Apolipoprotein E4; D005819:Genetic Markers
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