The Role Of Inflammatory Cytokines In Memory Impairment Caused By Depression Treated By MECT

ObjectiveDepression,also known as depressive disorder,is a serious mental illness that has a high prevalence and recurrence rate.It can even cause serious consequences such as self-harm and suicide.Depression brings huge economic pressure and mental burden to patients,families and society,and seriously threatens human health.It is estimated that by 2030,the number of years of lived with disability caused by depression will reach the world first One digit^[1,5].The pathogenesis of depression has not been known so far.Studies in recent years have shown that the occurrence of depression involves changes in immune inflammatory cytokines,and the changes in immune activators in depression patients may even affect depression treatment^[24].In terms of depression treatment,with the continuous emergence of new antidepressants,more and more drugs are available for depression treatment,and the treatment methods have become more and more diverse,although these drugs have greatly improved the treatment of depression Efficacy,but 30%-50%of patients still do not respond to monoamine-based medications^[25].Modified non-convulsive electrical shock therapy（MECT）is a very effective physical therapy for the treatment of major depression.It has a fast onset of time,high safety,and a rapid improvement in depression symptoms.It is widely used,but memory impairment has become a common side effect of patients after MECT treatment,especially in the early stage of treatment,mainly retrograde amnesia^[3-4],which seriously affects the patient’s learning life after MECT treatment and leads to patient treatment compliance.Drop or even interrupt treatment.If the above-mentioned side effects are not taken to prevent and improve,it will limit the vigorous development of MECT in the clinic.At present,little is known about the mechanism of memory impairment after MECT treatment in patients with depression.Experimental and clinical evidence shows that the development of cognitive processes may be related to immune inflammation mechanisms^[26].Therefore,it is necessary to explore the mechanism of immune inflammation in patients with depression and memory impairment after MECT treatment,in order to clinically solve the problem of memory impairment during MECT treatment of depression.Method（1）The study subjects were selected from 50 cases of depression patients inpatient and outpatient treatment at Kangning Hospital from January 2018 to December 2019 as the case group.All patients received the MECT treatment regimen under the same conditions,and the normal control group selected 50.There were no significant differences in the age,sex,weight and other indicators among healthy volunteers.（2）In the case group,5 ml of peripheral venous blood was taken from each patient before MECT treatment,and the blood levels of IL-1,IL-2,IL-6,IL-18,TGF-β,TNF-α,and NF-k B were detected by ELISA.After 10 times of MECT treatment,peripheral blood was drawn again,and the above operation was repeated.After the normal control group was enrolled,5 ml of peripheral venous blood was drawn.The treatment method was the same as the case control group.（3）Before the MECT treatment,the Hamilton Depression Scale（HAMD-17）was used to assess whether the patients in the case group met the conditions for enrollment.After the enrollment,the Wechsler Memory Scale（WMS）was used before MECT treatment and after 10 MECT treatments to evaluate patients’memory impairment status separately.（4）In this study,SPSS 19.0 statistical software（IBM Corporation,USA）was used to perform statistical analysis and processing on the collected data by using paired sample t test and multiple linear regression.All experimental data were expressed as mean±standard deviation,and p<0.05 was considered statistically significant.Result1.Statistical analysis of relevant experimental data of Wechsler memory scale and HAMD-17 scale showed that the p-values are less than0.01,which was statistically significant.2.Comparison between healthy control group and case group before MECT treatment:the p-values of IL-1,NF-k B are greater than 0.05,which is no statistical significance;the p-values of IL-2,IL-6,IL-18,TGF-β,TNF-αare all less than 0.05,which is statistically significant.It is suggested that the occurrence of depression may be related to changes in inflammatory cytokine levels.3.In addition to IL-2,the p-values of IL-1,NF-k B,IL-6,IL-18,TGF-β,and TNF-αare all less than 0.05,which is statistically significant.Preliminary verification of changes in plasma inflammatory cytokines in patients with depression before and after MECT treatment.4.Correlation analysis between the concentrations of inflammatory cytokines and WMS scores:The|r|values of IL-1,TGF-βand IL-18 are less than 0.4,and the p values are greater than0.05,indicating that there was no significant correlation or weak correlation between the inflammatory cytokine concentrations of IL-18,IL-1,TGF-βand Wechsler memory scale scores;the|r|values of IL-6 and NF-k B are greater than 0.2,and the p values are less than0.05.It is shown that the levels of inflammatory cytokines of IL-6and NF-k B are weakly negatively correlated with the results of the Wechsler Memory Scale;the values of|r|of IL-2 and TNF-αare greater than 0.4,and their p-values are less than 0.01,It shows that the levels of inflammatory cytokines of IL-2 and TNF-αhave a certain correlation with Wechsler memory scale score,especially the correlation coefficient of TNF-αis greater than 0.6,which proves that it has a strong negative correlation with Wechsler memory scale score.5.Multivariate linear regression analysis was performed using the concentrations of IL-6,IL-2,NF-k B,and TNF-αas the independent variables and WMS score as the dependent variable.Adjusting the R-squared value to 0.383 means that IL-6,IL-2,NF-k B and TNF-αcan explain the 38.3%change in WMS scores.When the F test was performed at the same time,it was found that the F test was passed（F=8.602,p<0.05）,which means that IL-6,IL-2 At least one of the concentrations of NF-k B and TNF-αwill affect the WMS score.In addition,testing for the multicollinearity of the data found that all VIF values in the data are less than 5,which means that there is no co-existence.;and the D-W value is near the number2,so there is no autocorrelation in the data,and there is no correlation between the sample data;the final specific analysis shows that the p values of IL-6,IL-2 and NF-k B are greater than 0.05,which means that the concentrations of IL-6,IL-2 and NF-k B will not affect the WMS score.The regression coefficient value of TNF-αconcentration is-0.108（t=-4.287,p<0.01）,which means that the concentration of TNF-αwill have a significant negative effect on the WMS score.Conclusion1.The concentrations of IL-2,IL-6,IL-18,TGF-β,and TNF-αin patients with depression are statistically significant compared with healthy controls,suggesting that the occurrence of depression may be related to the level of inflammatory cytokines.2.The Wechsler Memory Scale score was statistically significant before and after MECT treatment,suggesting that MECT treatment has a damaging effect on the memory function of patients with depression.The concentrations of IL-6,IL-2,NF-k B,TNF-αand WMS score has a certain degree of negative correlation,suggesting that MECT is a important indicator of memory function damage and its damage mechanism may be related to inflammatory cytokines.3.Multiple linear regression studies found that the correlation between TNF-αconcentration and WMS score was the strongest,showing a negative correlation,indicating that it can make a certain negative prediction of the degree of memory impairment in patients,that is,the higher the TNF-αconcentration in patients,The degree of memory impairment may be greater.