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However, a relevant number of patients experience subjective and\/or objective cognitive side-effects. The mechanism of these transient deficits is not yet clear. Thus, our study prospectively investigated neurofilament light chain (NfL) concentrations as a highly sensitive biomarker for neuroaxonal damage along with cognitive performance during a course of ECT. Serum NfL concentrations from 15 patients with major depressive disorder receiving ECT were analyzed (1) 24\u00a0h before the first ECT, (2) 24\u00a0h and (3) 7\u00a0days after the last ECT (45 measurements in total). Neuropsychological testing including memory, executive functions and attention was performed at each time-point. NfL concentrations did not change between the three time-points, while a temporary cognitive impairment was found. Even in the subset of patients with the strongest impairment, NfL concentrations remained unchanged. Neuropsychological testing revealed the common pattern of transient cognitive side-effects with reduced performance 24\u00a0h post-ECT (global cognition score: <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; memory: <jats:italic>p<\/jats:italic>\u2009=\u20090.043; executive functions: <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and return to baseline after 7\u00a0days (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Our study adds to the evidence that neither ECT per se nor the transient cognitive side-effects seem to be associated with an increase of NfL as a marker of neuroaxonal damage. In contrast, we discuss cognitive side effects to be potentially interpreted as a byproduct of ECT\u2019s neuroplastic effects.<\/jats:p>","DOI":"10.1007\/s00406-023-01686-8","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T07:02:34Z","timestamp":1693551754000},"page":"1187-1195","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The myth of brain damage: no change of neurofilament light chain during transient cognitive side-effects of ECT"],"prefix":"10.1007","volume":"274","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5612-2651","authenticated-orcid":false,"given":"Matthias","family":"Besse","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Belz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Bartels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Herzig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Wiltfang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Zilles-Wegner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,9,1]]},"reference":[{"key":"1686_CR1","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1056\/NEJMra2034954","volume":"386","author":"RT Espinoza","year":"2022","unstructured":"Espinoza RT, Kellner CH (2022) Electroconvulsive therapy. 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