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World J Psychiatry. Mar 19, 2026; 16(3): 114036
Published online Mar 19, 2026. doi: 10.5498/wjp.v16.i3.114036
Published online Mar 19, 2026. doi: 10.5498/wjp.v16.i3.114036
Clinical symptom improvement following modified electroconvulsive therapy is associated with modulation of peripheral inflammatory markers in schizophrenia
Lu Hou, Ru Chen, Cheng-Bing Huang, Wen-Jie Shi, Li-Li Wu, Department of Psychiatry, Huai’an Third People’s Hospital, Huai’an 223001, Jiangsu Province, China
Co-first authors: Lu Hou and Ru Chen.
Co-corresponding authors: Wen-Jie Shi and Li-Li Wu.
Author contributions: Hou L and Chen R contributed equally to this manuscript and are co-first authors. Shi WJ and Wu LL designed the study, and they contributed equally to this manuscript and are co-corresponding authors; Hou L analysed the data and wrote the manuscript; Chen R and Huang CB collected the relevant data and provided technological support; Shi WJ provided financial support; Hou L and Shi WJ edited the manuscript. All authors have read and approved the final manuscript.
Supported by the Huai’an Municipal Health Commission’s Natural Science Project, No. HAB202214.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee at Huai’an Third People’s Hospital (No. 2022-23).
Informed consent statement: All participants enrolled on this study provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
Corresponding author: Wen-Jie Shi, Academic Fellow, Chief Physician, Department of Psy
Received: September 11, 2025
Revised: October 21, 2025
Accepted: December 2, 2025
Published online: March 19, 2026
Processing time: 170 Days and 18.3 Hours
Revised: October 21, 2025
Accepted: December 2, 2025
Published online: March 19, 2026
Processing time: 170 Days and 18.3 Hours
Core Tip
Core Tip: This study demonstrates that modified electroconvulsive therapy significantly improves clinical symptoms and reduces peripheral inflammatory markers - including monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio, and systemic immune-inflammatory indices - in patients with schizophrenia. Reductions in MLR were strongly correlated with clinical improvement and served as a robust predictor of treatment response. Specifically, each 0.1-unit increase in ΔMLR was associated with a 57% higher likelihood of significant symptom improvement. These findings suggest an immunomodulatory mechanism of modified electroconvulsive therapy and support the use of MLR as a potential biomarker for predicting treatment efficacy.