Exploring the impact of modified electroconvulsive therapy on neutrophil-monocyte ratio in stupor: A novel insight into inflammatory mechanisms

Modified electroconvulsive therapy (MECT) is a common treatment for stupor, but its effects on inflammatory markers, particularly the neutrophil-monocyte ratio (NMR), are not well understood. This retrospective study aims to preliminarily compare the effects of MECT + pharmacotherapy with pharmacotherapy alone on NMR in patients with stupor, and to investigate the clinical factors influencing NMR change. Thirty-seven patients with stupor were divided into two groups based on treatment modality. Clinical efficacy, response time, demographic data, and blood inflammatory markers of the two groups were evaluated before and after treatment. Statistical comparisons were conducted using paired t-tests or Wilcoxon tests, and correlation analyses were performed. The MECT + pharmacotherapy group showed a higher response rate (χ2 = 4.98, p=0.026) and shorter response time compared to the pharmacotherapy-only group (Z = −2.45, p=0.014). NMR decreased after treatment in the MECT + pharmacotherapy group (t = 2.32, p=0.034). Post-treatment NMR correlated with age of onset (ρ=0.491, p=0.045), and the NMR ratio with disease classification (ρ=0.502, p=0.040); however, these associations did not remain significant after Bonferroni correction. MECT + pharmacotherapy shortened response time in patients with stupor, with a trend toward reduced NMR, suggesting a possible anti-inflammatory effect of MECT that warrants confirmation. Age of onset and disease classification may influence NMR changes. These conclusions require verification in larger studies.