AccScience Publishing / JCBP / Online First / DOI: 10.36922/JCBP025400079
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ORIGINAL RESEARCH ARTICLE

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

Zhiqian Liu1 ,  Huimin Gao2 ,  Zhimeng Yang2,3 ,  Chenchen Zhang2,3 ,  Rui Li2,3 ,  Xiaochi Yuan2,3 ,  Kun Li2,3* ,  Yuebing Zhang1,2,3*
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1 Department of Psychiatry, Jining Medical University, Jining, Shandong, China
2 Department of Physical Therapy, Shandong Daizhuang Hospital, Jining, Shandong, China
3 Jining Key Laboratory of Neuromodulation, Jining, Shandong, China
JCBP, 025400079 https://doi.org/10.36922/JCBP025400079
Received: 3 October 2025 | Revised: 16 November 2025 | Accepted: 15 December 2025 | Published online: 2 January 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

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.

Keywords
Stupor
Modified electroconvulsive therapy
Neutrophil–monocyte ratio
Inflammatory markers
Age of onset
Disease classification
Funding
This work was supported by the Shandong Provincial Natural Science Foundation (ZR2024QH385).
Conflict of interest
The authors declare they have no competing interests.
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