In particular, the rationale for these investigations came from the observation of inflammatory and immune dysfunction in patients with MDD, such as increased levels of cytokines including the interleukins 6 (IL-6) and 1-Beta (IL-1β), the tumor necrosis factor-alpha (TNF-α), and the C-reactive protein (CRP), especially in TRD, for which ECT represents one of the most effective treatments. The gene discussed is TNF; the disease is immune system disorder.