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However, our knowledge of the ECT-induced molecular mechanisms causing clinical improvement is limited. To address this issue, we developed the single-center, prospective observational DetECT study (\u201cMultimodal Biomarkers of ECT in TRD\u201d; registered 18\/07\/2022,\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicalTrials.gov\">www.clinicalTrials.gov<\/jats:ext-link>\n                    , NCT05463562). Its objective is to identify molecular, psychological, socioeconomic, and clinical biomarkers of ECT response in TRD. We aim to recruit\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009134 patients in 3\u00a0years. Over the course of 12 biweekly ECT sessions (\u00b1\u20097\u00a0weeks), participant blood is collected before and 1\u00a0h after the first and seventh ECT and within 1 week after the twelfth session. In pilot subjects (first\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200910), additional blood draws are performed 3 and 6\u00a0h after the first ECT session to determine the optimal post-ECT blood draw interval. In blood samples, multiomic analyses are performed focusing on genotyping, epigenetics, RNA sequencing, neuron-derived exosomes, purines, and immunometabolics. To determine clinical response and side effects, participants are asked weekly to complete four standardized self-rating questionnaires on depressive and somatic symptoms. Additionally, clinician ratings are obtained three times (weeks 1, 4, and 7) within structured clinical interviews. Medical and sociodemographic data are extracted from patient records. The multimodal data collected are used to perform the conventional statistics as well as mixed linear modeling to identify clusters that link biobehavioural measures to ECT response. The DetECT study can provide important insight into the complex mechanisms of ECT in TRD and a step toward biologically informed and data-driven-based ECT biomarkers.\n                  <\/jats:p>","DOI":"10.1007\/s00406-023-01647-1","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T23:25:13Z","timestamp":1693351513000},"page":"673-684","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Multiomics and blood-based biomarkers of electroconvulsive therapy in severe and treatment-resistant depression: study protocol of the DetECT study"],"prefix":"10.1007","volume":"274","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5021-9495","authenticated-orcid":false,"given":"Iven-Alex","family":"von M\u00fccke-Heim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius C.","family":"Pape","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norma C.","family":"Grandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelika","family":"Erhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan M.","family":"Deussing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth B.","family":"Binder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"1647_CR1","unstructured":"World Health Organization, (2017) Depression and Other Common Mental Disorders: Global Health Estimates. 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