Propofol interacts with stimulus intensities of electroconvulsive shock to regulate behavior and hippocampal BDNF in a rat model of depression

As a psychiatric treatment, modern electroconvulsive therapy (ECT) requires anesthesia to enhance safety, but anesthetics may weaken its efficacy. Previous studies have provided inconsistent results and lack satisfactory details of the influence of anesthetics on ECT efficacy, which partially complicates the clinical selection of ECT protocols. To test our hypothesis that anesthetics interact with the intrinsic parameters of ECT to differentially regulate its therapeutic efficacy, we investigated the effects of the anesthetic propofol and the stimulus intensities of ECT on behavior and hippocampal brain-derived neurotrophic factor (BDNF) in a rodent model of depression. After treatment with chronic unpredictable mild stresses to produce the model, the depressed rats received anesthesia with propofol or normal saline, i.p., and electroconvulsive shock (ECS, an analog of ECT to animals) with different stimulus intensities. The sucrose preference and open field tests were performed to assess behavior, and BDNF level in hippocampus was measured with ELISA. We found that propofol regulated the efficacy of ECS differently at different stimulus intensities in both the behavioral and molecular levels. At medium intensities (120 and 180 mC), propofol enhanced the anti-depressant efficacy of ECS without largely compromising the recovering efficacy of ECS on spontaneous exploratory activities. The results indicated that propofol and ECS stimulus intensities interacted and resulted in different regulating efficacies at different intensities. Medium stimulus intensities were optimal for ECS efficacy under propofol anesthesia.