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血清脑源性神经营养因子(BDNF)与电休克治疗(ECT)的反应无关:一项针对耐药性抑郁症患者的初步研究。

Serum brain-derived neurotrophic factor (BDNF) is not associated with response to electroconvulsive therapy (ECT): a pilot study in drug resistant depressed patients.

作者信息

Fernandes Brisa, Gama Clarissa S, Massuda Rafael, Torres Mariana, Camargo Daniel, Kunz Mauricio, Belmonte-de-Abreu Paulo Silva, Kapczinski Flávio, de Almeida Fleck Marcelo Pio, Inês Lobato Maria

机构信息

Bipolar Disorder Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.

出版信息

Neurosci Lett. 2009 Apr 10;453(3):195-8. doi: 10.1016/j.neulet.2009.02.032. Epub 2009 Feb 21.

Abstract

Refractory depression is a highly debilitating mental condition that originates major social and economic burden. About 50% of the patients experience a chronic course of illness and up to 20% show an insufficient response to drug treatments. Electroconvulsive therapy (ECT) is the most effective treatment method in refractory depression, although its mechanism of action is still unknown. Brain-derived neurotrophic factor (BDNF) is decreased in depressive episodes, and increases with antidepressant treatment, being suggested as a biomarker of response to ECT. We report the findings of a study on the effects of ECT on BDNF and clinical outcomes in a group of drug resistant depressive patients before and after ECT. The patients post-ECTs have shown an important improvement of depressive symptomatology on the HDRS (p=0.001), of psychotic features on the BPRS (p=0.001) and of the severity of illness on the CGI (p=0.001). There were no changes in the serum BDNF before and after the ECT treatment (p=0.89). These results do not support the hypothesis that the clinical improvement following ECT is due to changes in the BDNF.

摘要

难治性抑郁症是一种极具致残性的精神疾病,会带来重大的社会和经济负担。约50%的患者经历慢性病程,高达20%的患者对药物治疗反应不佳。电休克疗法(ECT)是难治性抑郁症最有效的治疗方法,尽管其作用机制尚不清楚。脑源性神经营养因子(BDNF)在抑郁发作时减少,随抗抑郁治疗而增加,被认为是ECT反应的生物标志物。我们报告了一项关于ECT对一组耐药性抑郁症患者ECT前后BDNF及临床结局影响的研究结果。ECT治疗后的患者在汉密尔顿抑郁量表(HDRS)上抑郁症状有显著改善(p=0.001),在简明精神病评定量表(BPRS)上精神病性特征有显著改善(p=0.001),在临床总体印象量表(CGI)上疾病严重程度有显著改善(p=0.001)。ECT治疗前后血清BDNF无变化(p=0.89)。这些结果不支持ECT后临床改善是由于BDNF变化的假说。

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