Pigment epithelium-derived factor (PEDF) in the therapeutic response to Electroconvulsive Therapy (360G-Wellcome-206841_Z_17_Z)

Depression is one of the leading contributors to the global burden of disease. One third of depressed people have treatment-resistance and don’t respond to standard antidepressant medications and/or psychological therapies. Such patients may benefit from electroconvulsive therapy (ECT), the most effective treatment for severe depression. Changes in brain plasticity are implicated in depression and the mechanism of action of antidepressant treatments. We recently discovered that a neurotrophic factor called PEDF (pigment epithelium derived factor) is increased in the blood of severely depressed patients following ECT. Interestingly, we also found similar changes in rat brain following chronic treatment with electroconvulsive stimulation. To extend these novel findings, we now aim to explore how blood levels of PEDF might be associated with remaining well following successful ECT and if this might be useful for predicting depression relapse. We already have clinical details and blood samples from over 100 patients with severe depression who participated in a now-completed randomised ECT trial (The EFFECT-Dep Trial). At present, we have no clinically useful "blood test" to help us in managing depression. So, any practical development in such a test would be an important clinical advance for patients with depression.