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Telomere length in depression and association with therapeutic response to electroconvulsive therapy and cognitive side-effects

Published online by Cambridge University Press:  03 September 2019

Karen M. Ryan Open the ORCID record for Karen M. Ryan [Opens in a new window]  and
Declan M. McLoughlin Open the ORCID record for Declan M. McLoughlin [Opens in a new window]
Karen M. Ryan
Affiliation:
Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland Department of Psychiatry, St. Patrick's University Hospital, Trinity College Dublin, James Street, Dublin 8, Ireland
Declan M. McLoughlin*
Affiliation:
Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland Department of Psychiatry, St. Patrick's University Hospital, Trinity College Dublin, James Street, Dublin 8, Ireland
*
Author for correspondence: Declan M. McLoughlin, E-mail: d.mcloughlin@tcd.ie
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Abstract

Background

Electroconvulsive therapy (ECT) is the most acutely effective treatment for severe treatment-resistant depression. However, there are concerns about its cognitive side-effects and we cannot yet confidently predict who will experience these. Telomeres are DNA-protein complexes that maintain genomic integrity. In somatic cells, telomeres shorten with each cell division. Telomere length (TL) can thus provide a measure of ‘biological’ aging. TL appears to be reduced in depression, though results are mixed. We sought to test the following hypotheses: (1) that TL would be shorter in patients with depression compared to controls; (2) that TL would be a predictor of response to ECT; and (3) that shorter TL would predict cognitive side-effects following ECT.

Method

We assessed TL in whole blood DNA collected from severely depressed patients (n = 100) recruited as part of the EFFECT-Dep Trial and healthy controls (n = 80) using quantitative real-time polymerase chain reaction. Mood and selected cognitive measures, including global cognition, re-orientation time, and autobiographical memory, were obtained pre-/post-ECT and from controls.

Results

Our results indicate that TL does not differ between patients with depression compared to controls. TL itself was not associated with mood ratings and did not predict the therapeutic response to ECT. Furthermore, shorter baseline TL is not a predictor of cognitive side-effects post-ECT.

Conclusions

Overall, TL assessed by PCR does not represent a useful biomarker for predicting the therapeutic outcomes or risk for selected cognitive deficits following ECT.

Keywords

Cognitive outcomesdepressionelectroconvulsive therapyside-effecttelomere
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 12 , September 2020 , pp. 2096 - 2106
Copyright
Copyright © Cambridge University Press 2019

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Footnotes

Meeting Presentation: Preliminary data from this manuscript were presented at the Society of Biological Psychiatry 71st Annual Meeting in Atlanta, Georgia, USA in 2016 and at the EMBO Telomeres, Telomerase and Disease meeting in Liège, Belgium in 2016.

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