Figure 2.

Schematic diagram of electroconvulsive therapy and astrocytes. Electroconvulsive therapy (ECT) increases extracellular ATP (ATPo), which in turn activates microglia from a resting to an activated phenotype. Acute ECT causes the transient activation of microglia and increases levels of many active molecules, such as proinflammatory cytokines and ATP. These diffusible molecules produced by activated microglia act on further astrocytes and cause their activation. Activated astrocytes increase levels of trophic factors, such as BDNF, VEGF, FGF, and also cytokines, such as IL-6, which cause synapse and network remodeling. These astrocyte events are involved in antidepressive effects.