Impact of Inflammation on Cognitive Functioning After Electroconvulsive Therapy in Older Patients with Depression with and Without White Matter Hyperintensities

Objective: Should we treat older, patients with depression with white matter hyperintensities (WMH) with electroconvulsive therapy (ECT)? WMH, inflammation, depression and cognitive functioning are suggested to be intertwined. Hence, this study investigates whether the association between inflammation and cognition is different in patients with depression with or without WMH. Methods: Cognitive functioning was assessed using the Mini–Mental State Examination during and after a course of ECT in 77 older patients with depression. Serum samples (C–reactive protein [CRP], interleukin-6 [IL-6], interleukin-10 [IL-10] and tumour necrosis factor–alpha [TNF-α]) and 3T magnetic resonance imaging were obtained prior to ECT. Results: An interaction effect was found for IL-10, but not for CRP, IL-6 or TNF-α. Conclusion: In general, the association between inflammatory markers and cognition in patients with depression treated with ECT is not different in patients with WMH compared to patients without WMH