OBJECTIVE Electroconvulsive therapy (ECT) is an effective option for treatment-resistant bipolar disorder (trBD). However, the mechanisms of its effect are unknown. Oxidative stress is thought to be involved in the underpinnings of BD. Our study is the first, to our knowledge, to report the association between notable oxidative stress parameters (superoxide dismutase [SOD], glutathione peroxidase [GSH-Px], catalase [CAT], and malondialdehyde [MDA]) levels and ECT response in trBD patients. METHODS A total 28 trBD patients and 49 controls were recruited. Six-week ECT and naturalistic follow-up were conducted. SOD, GSH-Px, CAT, and MDA levels were measured by enzyme-linked immunosorbent assay, and the 17-item Hamilton Depression Rating Scale and Young Mania Rating Scale were administered at baseline and the end of the 6th week. MANCOVA, ANCOVA, 2 × 2 ANCOVA, and a multiple regression model were conducted. RESULTS SOD levels were lower in both trBD mania and depression (P = .001; P = .001), while GSH-Px (P = .01; P = .001) and MDA (P = .001; P = .001) were higher in both trBD mania and depression compared with controls. CAT levels were positively associated with 17-item Hamilton Depression Rating Scale scores in trBD depression (radjusted  = 0.83, P = .005). MDA levels in trBD decreased after 6 weeks of ECT (P = .001). Interestingly, MDA levels decreased in responders (P = .001) but not in nonresponders (P > .05). CONCLUSIONS Our study indicates that decreased SOD could be a trait rather than a state in trBD. Oxidative stress levels are associated with illness severity and ECT response. This suggests that the mechanism of oxidative stress plays a crucial role in the pathophysiology of trBD.

中文翻译：

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抗氧化性双相情感障碍中氧化应激参数的扰动及其与电惊厥治疗反应的关系。

目的电惊厥疗法（ECT）是治疗难治性躁郁症（trBD）的有效选择。但是，其作用机理尚不清楚。氧化应激被认为与BD的基础有关。据我们所知，我们的研究是第一个报告显着氧化应激参数（超氧化物歧化酶[SOD]，谷胱甘肽过氧化物酶[GSH-Px]，过氧化氢酶[CAT]和丙二醛[MDA]）水平与ECT响应之间的关系的研究。 trBD患者。方法总共招募了28名trBD患者和49名对照。进行了为期六周的ECT和自然随访。通过酶联免疫吸附测定法测定SOD，GSH-Px，CAT和MDA的水平，并在基线和第6周结束时使用17个项的汉密尔顿抑郁量表和年轻躁狂症量表。曼科瓦，安科瓦，进行2×2 ANCOVA，并进行多元回归模型。结果trBD躁狂症和抑郁症的SOD水平均较低（P = .001; P = .001），而GSH-Px（P = .01; P = .001）和MDA（P = .001; P = .001）与对照相比，trBD躁狂症和抑郁症的患病率均更高。CAT水平与trBD抑郁症中的17个项的汉密尔顿抑郁量表评分得分呈正相关（校正后= 0.83，P = .005）。ECT治疗6周后，trBD中的MDA水平下降（P = .001）。有趣的是，应答者的MDA水平降低（P = .001），而无应答者的MDA水平却没有降低（P> .05）。结论我们的研究表明，降低的SOD可能是trBD的一个特征而不是状态。氧化应激水平与疾病的严重程度和ECT反应有关。