| Summary: | Background: The management and treatment of major depressive disorder are major public health challenges, the lifetime prevalence of this illness being 4.4%–20% in the general population. Major depressive disorder and treatment resistant depression appear to be, in part, related to a dysfunction of the immune response. Among the treatments for depression ECT occupies an important place. The underlying cerebral mechanisms of ECT remain unclear. Objectives/Hypothesis: The aim of this review is to survey the potential actions of ECT on the immuno-inflammatory cascade activated during depression. Methods: A systematic search of the literature was carried out, using the bibliographic search engines PubMed and Embase. The search covered articles published up until october 2017.The following MESH terms were used: Electroconvulsive therapy AND (inflammation OR immune OR immunology). Results: Our review shows that there is an acute immuno-inflammatory response immediately following an ECT session. There is an acute stress reaction. Studies show an increase in the plasma levels of cortisol and of interleukins 1 and 6. However, at the end of the course of treatment, ECT produces, in the long term, a fall in the plasma level of cortisol, a reduction in the levels of TNF alpha and interleukin 6. Limitations: One of the limitations of this review is that a large number of studies are relatively old, with small sample sizes and methodological bias. Conclusion: Advances in knowledge of the immuno-inflammatory component of depression seem to be paving the way towards models to explain the mechanism of action of ECT.
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