Changes Of Inflammatory Factors In Schizophrenia Before And After Modified Electroconvulsive Therapy

Objective: To compare the difference serum levels of interleukin-1?(IL-1?),interleukin-6(IL-6),tumor necrosis factor-?(TNF-?)and interferon-?(IFN-?)between before and after Modified Electroconvulsive Therapy in patients with schizophrenia. And explore the relationship between the efficacy of electroconvulsive therapy and the levels of these pro-inflammatory factors,to preliminary clarify the possible causes of inflammation in patients with schizophrenia.Methods: In accordance with the International Classification of Diseases 10(ICD-10)diagnosis criteria for schizophrenia,aged between 18 and 60 years,treated with Modified Electroconvulsive Therapy,a total of 42 patients were included in the study group.Before the electroconvulsive therapy and within 3 days after the electroconvulsive therapy,Collect peripheral blood,collect clinical data from the subjects,use the Positive and Negative Syndrome Scale(PANSS)to assess the severity of mental symptoms.Use the Enzyme-linked Immunosorbent Assay(ELISA)to compare the difference serum levels of interleukin-1?(IL-1?),interleukin-6(IL-6),tumor necrosis factor-?(TNF-?)and interferon-?(IFN-?)between before and after electroconvulsive therapy.Results: 1.A total of 42 patients with schizophrenia were included in this study,which were divided into introverts(35 cases,76.20%)and extroverts(7 cases,16.70%)by personality;divided into males(20 cases,47.62%),female(22 cases,52.38%)by gender;divided into negative(34 cases,80.95%)and positive(8 cases,19.05%)according to family history.The average age is 30 years,the average course of disease is 8 years,and the average BMI is 23.29.2.The Kolmogorov-Smirnov normal test before and after scoring of each scale followed a normal distribution.Before MECT : the total score of the PANSS scale was:112.071 ± 19.429,the score of the positive symptom scale:27.000 ± 6.757,and the score of the negative symptom scale: 36.048 ± 8.743,general psychopathological scale score: 49.024 ± 12.460;After MECT: total score of PANSS scale: 76.571 ± 18.934,positive symptom scale score: 14.952 ± 7.067,negative symptom scale score: 29.048 ± 7.467,the general pathology scale score is: 33.143 ± 10.276.Paired sample t test was used between the two groups before and after treatment,and the results were as follows: Total score of PANSS scale(t = 9.051,P<0.001),positive scale score(t = 10.051,P<0.001),negative scale score(t =5.284,P<0.001)and general psychopathology scale score(t=6.521,P<0.001)were significantly lower than those before modified electroconvulsive therapy,and the difference was statistically significant.There was no significant difference in the efficacy of modified electroconvulsive therapy among patients with schizophrenia of different gender,personality and family history.3.Compare the difference serum levels of interleukin-1?(IL-1?),interleukin-6(IL-6),tumor necrosis factor-?(TNF-?)and interferon-?(IFN-?)between before and after electroconvulsive therapy Using ShapiroWilk normal test,it was found that none of them obeyed normal distribution.Therefore,the median was chosen to statistically describe these values,and the Wilcoxon signed rank sum test was used to statistically analyze the levels before and after treatment.before modified electroconvulsive therapy the median of IL-1?,IL-6,TNF-?,and IFN-? were 34.78 pg / m L,20.18 ng / L,356.19 ng / L,and 483.76 ng / L.after the modified electroconvulsive therapy the median of IL-1?,IL-6,TNF-?,and IFN-? were 29.81 pg / m L,18.47 ng / L,372.19 ng / L,and 500.94 ng / L.There was no significant difference in serum levels between the matched groups before and after treatment with IL-6,TNF-?,and IFN-?(P=0.055,P=0.352,P=0.103).There was significant difference in serum levels between the matched groups before and after treatment with IL-1?(P<0.001).4.Use Pearson correlation analysis found that the course of disease was negatively correlated with the serum levels of TNF-?(r=-0.316)and IFN-?(r=-0.318)in patients,with significant differences(P<0.05);There was no significant correlation between age,BMI and serum inflammatory factors;Use nonparametric Mann-Whitney U test with two independent samples to analyze discontinuous variables,and no significant correlation was found between the patient's personality,gender,family history,and serum inflammation level.5.The changes of IL-1?,IL-6,TNF-?,IFN-? serum level between before and after MECT had no significant correlation with the changes in positive symptoms scale,negative symptoms scale,general pathological scale score,and total score in the PANSS scale;Conclusions: 1.MECT is effective and rapid in the treatment of schizophrenia,and the curative effect has nothing to do with gender,personality and family history.2.MECT treatment reduces the serum IL-1? level in patients with schizophrenia.Modified Electroconvulsive Therapy may change the expression of some inflammatory factors and the symptoms of mental patients are improved.Inflammatory factors may play a special role in the treatment and pathogenesis of patients with schizophrenia.3.The course of disease affects the level of inflammatory factors in patients with schizophrenia.The longer the course of disease,the lower the level of inflammatory factors.Patients with longer disease duration have lower serum TNF-? and IFN-? levels.