Seda KIRCI ERCAN
Meandros Medical and Dental Journal - 2026;27(3):423-429
Objective: Electroconvulsive therapy (ECT) may influence immune and inflammatory pathways; however, evidence regarding early changes in CBC-derived inflammatory indices remains limited. The aim of this study was to evaluate post-treatment changes in composite inflammatory indices derived from complete blood count parameters in patients undergoing ECT and to determine whether these changes differed across diagnostic groups. Materials and Methods: This retrospective study included patients treated with ECT between March 2021 and November 2025 at Adnan Menderes University Hospital. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) were calculated from CBC data obtained at least 24 hours before the first ECT session and within 24 hours after the final ECT session. Pre-post comparisons were performed using the Wilcoxon signed-rank test, and effect sizes were calculated as r=|Z|/?N. Results: A total of 130 patients were included in the study. In the overall sample, no statistically significant changes were observed between pre- and post-ECT values of NLR, PLR, MLR, SII, SIRI, or AISI (all p>0.05), and effect sizes were small or negligible. Subgroup analyses revealed a significant change in NLR in the bipolar mania group (p=0.047) and significant changes in SIRI and AISI in the group classified as other diagnoses (both p=0.048). No significant or consistent changes were observed in the remaining diagnostic groups. No statistical correction for multiple comparisons was applied in the subgroup analyses. Conclusion: ECT was not associated with significant early post-treatment changes in CBC-derived inflammatory indices at the whole-sample level. However, limited subgroup-specific findings suggest that inflammatory responses to ECT may vary according to clinical phenotype and timing of measurement. Prospective studies with repeated sampling and adjustment for potential confounders are warranted.
