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Blood samples were collected at baseline and post\u2010ECT. Plasma ADEVs were isolated and confirmed, and the concentrations of two astrocyte markers (glial fibrillary acidic protein [GFAP] and S100\u03b2), an extracellular vesicle marker cluster of differentiation 81 (CD81), and nine inflammatory markers in ADEVs were measured as main analyses. In addition, correlation analysis was conducted between clinical features and ADEV protein levels as exploratory analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, the TRD group exhibited significantly higher levels of two astrocyte markers GFAP and S100\u03b2, as well as CD81 compared with the healthy controls. Inflammatory markers interferon \u03b3 (IFN\u2010\u03b3), interleukin (IL) 1\u03b2, IL\u20104, IL\u20106, tumor necrosis factor \u03b1, IL\u201010, and IL\u201017A were also significantly higher in the TRD group. After ECT, there was a significant reduction in the levels of GFAP, S100\u03b2, and CD81, along with a significant decrease in the levels of IFN\u2010\u03b3 and IL\u20104. Furthermore, higher levels of GFAP, S100\u03b2, CD81, and inflammatory cytokines were associated with more severe depressive symptoms and poorer cognitive function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides direct insight supporting the astrocyte activation and neuroinflammatory hypothesis of depression using ADEVs. ECT may exert an anti\u2010inflammatory effect through inhibition of such activation of astrocytes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pcn.13596","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T11:40:53Z","timestamp":1694086853000},"page":"653-664","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Human <i>in vivo<\/i> evidence of reduced astrocyte activation and neuroinflammation in patients with treatment\u2010resistant depression following electroconvulsive therapy"],"prefix":"10.1111","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3769-2525","authenticated-orcid":false,"given":"Shu\u2010xian","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Psychiatry Renmin Hospital of Wuhan University  Wuhan Hubei 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