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Epigenetic Effects of Electroconvulsive Seizures

de Jong, Job O.Z. BSc*; Arts, Baer MD*; Boks, Marco P. MD, PhD; Sienaert, Pascal MD, PhD; van den Hove, Daniel L.A. PhD*; Kenis, Gunter PhD*; van Os, Jim MD, PhD; Rutten, Bart P.F. MD, PhD*

doi: 10.1097/YCT.0000000000000141
Invited Reviews

Electroconvulsive therapy (ECT) is one of the most effective methods for managing treatment-resistant depression. Although the proposed mechanisms of action have thus far mainly been investigated at the cellular level, recent observations and developments in the field of molecular biology and genomics have provided novel insights in the actual molecular underpinnings of dynamic alterations in gene expression, particularly in response to environmental exposures, and experience-dependent plasticity, both of which are highly relevant to ECT. Here, we provided a brief background on epigenetics and we reviewed the current state of knowledge on epigenetic mediation of ECT-related therapeutic effects. We performed a systematic search on the effects of ECT on epigenetics and found only a limited number on animal studies relevant to our search. These studies, however, support the notion of a robust impact of ECT on epigenetic mechanisms and set the stage for human ECT studies on the epigenetic machinery.

From the *Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, European Graduate School of Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht; †Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands; ‡Department of Mood Disorders and ECT, University Psychiatric Center, Catholic University Leuven, Leuven, Belgium; and §Department of Psychosis Studies, Institute of Psychiatry, King’s College London, King’s Health Partners, London, UK.

Received for publication January 4, 2014; accepted March 18, 2014.

Reprints: Bart P.F. Rutten, MD, PhD, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands (e-mail:

The authors have no conflicts of interest or financial disclosures to report.

© 2014 by Lippincott Williams & Wilkins