Barcelona snapshots

Prof. Bernhard Baune

Bernhard Baune psychiatrist Controversies Psiquiatry Barcelona
Universität Münster, Germany & University of Melbourne, Australia
Talk Predicting clinical response to ECT using omics techniques
Date Thursday, April 20th, 2023
Time 18:00 - 18:45
Round Table 1 Precision neuromodulation in psychiatric disorders: from ancient to novel therapies


Prof. Bernhard Baune (PhD, MD, MPH, MBA, FRANZCP) holds a Professorial Chair of Psychiatry, is Head of the Department of Psychiatry and the Director of the Laboratory Division of Molecular Neurobiology of Mental Health at the University of Münster, Münster, Germany since 2019. Previously, Prof. Baune has been the Cato Chair and Head of Department of Psychiatry at the University of Melbourne, Australia. Prof. Baune is a Fellow of the Royal Australian and New Zealand College of Psychiatrist (FRANZCP), he is a Professorial Fellow of the Department of Psychiatry, University of Melbourne and also at the Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Australia.

Prof. Baune is known for his extensive research program into the neurobiology of severe mental illness and treatment response, specifically in mood disorders, cognitive dysfunction and neuropsychiatry. He developed novel concepts and approaches in personalised psychiatry, molecular psychiatry, prediction and biomarker research and pharmacological treatment research. He is also well known for key research achievements in the field of the immune-neurobiology of psychiatric disorders.

He is currently the Lead PI of two EU funded projects that investigate the neurobiology and molecular foundations of treatment response (EraPerMed: PROMPT consortium) in major depressive disorder and the early detection and early treatment of treatment resistance in major psychiatric disorders (MDD, Bipolar disorder, Schizophrenia) (Horizon Europe: Psych-STRATA consortium). Moreover, he is the chair of the ECNP European network Pharmacogenomics and Transcriptomics of Neuropsychiatric Disorders. In addition, he leads the International consortium on the genomics of severe depression and response to ECT in affective disorders (GenECT-ic). His research approach aims at the discovery of novel treatment targets and eventually at personalising treatments in order to make real-world differences to the lives of people with mental illness.

His research is nationally and internationally widely recognized, has been funded by >35 Million Euros (e.g., NHMRC - Australia, EU EraPerMed, Horizon Europe, DFG –Germany) and he has published more than >655 peer-reviewed articles, reviews and book chapters (H-Index 87; >50,000 citations; Science, Nature, Lancet, Nature Genetics, N Eng J Med, JAMA Psychiatry, Lancet Psychiatry, Mol Psychiatry, Biol Psychiatry, Neuropsychopharmacology). He edited several textbooks in Psychiatry, and most recently the books “Personalised Psychiatry” (Elsevier), “Inflammation and Immunity of Depression” (Elsevier) and “Cognitive Dimensions of Major Depressive Disorder” (Oxford University Press).


Electroconvulsive therapy (ECT) represents an effective intervention for treatment-resistant depression (TRD) and selected other severe psychiatric conditions. A priority of this research field is the clarification of ECT response mechanisms and the identification of biomarkers predicting outcomes. Most of the investigations on the biological underpinning of the mechanisms of ECT point towards biological systems related to major depressive disorder (MDD), including the neurotrophic and inflammatory/immune system. Studies about neurotrophins, like the brain-derived neurotrophic factor (BDNF) and the vascular endothelial growth factor (VEGF), have shown evidence for neurotrophic effects of ECT as potential biological mechanism. Studies in the immune system suggest an acute stress reaction following an ECT session. However, at the end of the treatment, ECT seems to induce a reduction in inflammatory-associated biomarkers such as cortisol, TNF-alpha and interleukin 6. Other biological systems, including the monoaminergic and the endocrine, have been sparsely investigated. Most of the studies so far have been focussed on one or a few markers and many studies in the field are relatively old, with small sample sizes and methodological biases. An example of this approach show an analysis of specific risk genes that appear predictive in imaging genetics analyses, such as the impact of DRD3 gene variation on ECT response, potentially mediated by alteration of striatal engagement during the processing of emotionally rewarding stimuli.

However, recent genome-wide association studies have demonstrated that the genetic burden associated with depression correlates with depression severity. Therefore, conducting genetic studies on patients at the most severe end of the depressive disorder spectrum, those with treatment-resistant depression and who are prescribed electroconvulsive therapy (ECT), could lead to a better understanding of the genetic underpinnings of severe depression and ECT response, respectively. To this end, recent findings indicate that ECT cohorts show an increased genetic burden for MD and are consistent with the hypothesis that treatment-resistant MD patients represent a subgroup with an increased genetic risk for MD. Moreover, polygenic risk scores (PRSs) carry clinical potential, but associations with treatment response in psychiatry are seldomly reported. In a recent analysis, the association between PRSs for major depressive disorder and schizophrenia (SCZ) with ECT response uncovered a linear association between PRS-SCZ and ECT outcome. Although it is too early to adopt PRSs in ECT clinical decision making, such findings strengthen the positioning of PRS-SCZ as a relevant biomarker to predict treatment response across disorders, as suggested in recent studies on treatment response in bipolar disorder. To date, gene expression studies on transcripts and microRNAs are rare and need further exploration.

To further enhance the understanding of the genomics of severe depression and ECT response, researchers and ECT providers from around the world and from various depression and ECT networks have formed the Genetics of ECT International Consortium (Gen-ECT-ic). This largest genomic study on treatment response in ECT will shed further light onto the genomic underpinnings of ECT.


[Full paper] Maffioletti E, Carvalho Silva R, Bortolomasi M, Baune BT, et al. (2021). Molecular Biomarkers of Electroconvulsive Therapy Effects and Clinical Response: Understanding the Present to Shape the Future. Brain Sci. 2021 Aug 25;11(9):1120. doi: 10.3390/brainsci11091120. PMID: 34573142; PMCID: PMC8471796.

[Full paper] Foo JC, Streit F, Frank J, Witt SH, Treutlein J; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium; Baune BT, et al (2018). Evidence for increased genetic risk load for major depression in patients assigned to electroconvulsive therapy. Am J Med Genet B Neuropsychiatr Genet. 2019 Jan;180(1):35-45. doi: 10.1002/ajmg.b.32700. Epub 2018 Dec 2. PMID: 30507021; PMCID: PMC6368636.

[Full paper] Luykx JJ, ..., Baune BT, , et al (2021). Interrogating Associations Between Polygenic Liabilities and Electroconvulsive Therapy Effectiveness. Biol Psychiatry. 2022 Mar 15;91(6):531-539. doi: 10.1016/j.biopsych.2021.10.013. Epub 2021 Oct 24. PMID: 34955169.

[Full paper] Soda T, ..., Baune BT. International Consortium on the Genetics of Electroconvulsive Therapy and Severe Depressive Disorders (Gen-ECT-ic). Eur Arch Psychiatry Clin Neurosci. 2020 Oct;270(7):921-932. doi: 10.1007/s00406-019-01087-w. Epub 2019 Dec 4. PMID: 31802253; PMCID: PMC7385979.

[Full paper] International Consortium on Lithium Genetics (ConLi+Gen); Amare AT, ..., Baune BT. Association of Polygenic Score for Schizophrenia and HLA Antigen and Inflammation Genes With Response to Lithium in Bipolar Affective Disorder: A Genome-Wide Association Study. JAMA Psychiatry. 2018 Jan 1;75(1):65-74. doi: 10.1001/jamapsychiatry.2017.3433. PMID: 29121268; PMCID: PMC5833535.