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
Bipolar Disorder Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Neurosci Lett. 2009 Apr 10;453(3):195-8. doi: 10.1016/j.neulet.2009.02.032. Epub 2009 Feb 21.
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.
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。
