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接受度洛西汀治疗的重度抑郁患者的视网膜电图评估:应答者和无应答者之间的差异是否表明存在不同的生物学背景?

Electroretinographic assessment in major depressed patients receiving duloxetine: might differences between responders and non-responders indicate a differential biological background?

机构信息

Department of Neurosciences, Ophthalmology and Genetics - Section of Psychiatry, University of Genova, Italy.

出版信息

J Affect Disord. 2011 Dec;135(1-3):154-9. doi: 10.1016/j.jad.2011.07.013. Epub 2011 Aug 4.

Abstract

INTRODUCTION

Despite intense research efforts, still too little is known about the biological determinants of depression, thus soliciting diverse study approaches. Among others, the electroretinography (ERG) has been proposed even as a putative proxy (retinal) measurement of central dopaminergic activity for Major Depressive Disorder (MDD) both in drug-naïve patients and subjects receiving antidepressant treatments. Nonetheless, current evidences are merely preliminary, essentially considering just older classes of antidepressants, thus requiring confirmation studies even with newer agents as duloxetine.

METHOD

Twenty MDD subjects and 20 matched controls received duloxetine 60 mg/day for 12 weeks, being monitored both by standard ERG recording and by administration of the Hamilton scales for Depression and Anxiety and the Young Mania Rating Scale at baseline and week 12 (end of the study).

RESULTS

ERG mean rod b-wave amplitude significantly reduced from baseline to week 12 in those depressed subjects achieving final response (p=.024), decreasing from the highest rank values to the ones, substantially unmodified, seen among non-responders and controls.

LIMITATIONS

Small sample size and lack of multiple assessments.

CONCLUSIONS

At least some MDD patients responding to duloxetine might exhibit a peculiar ERG pattern, hypothetically indicating a specific biological background. If confirmed by larger-sampled studies, these results might shed further light in the understanding of the biological determinants of different subtypes of depression, ideally showing alternative patterns of response upon different treatment interventions.

摘要

简介

尽管进行了大量研究,但人们对抑郁症的生物学决定因素仍知之甚少,因此需要采用多种研究方法。其中,视网膜电图(ERG)甚至被提议作为一种潜在的(视网膜)测量中央多巴胺活性的方法,用于评估未接受药物治疗的患者和接受抗抑郁治疗的患者的重度抑郁症(MDD)。尽管如此,目前的证据仅仅是初步的,主要考虑的是较老的抗抑郁药类别,因此需要通过新的药物(如度洛西汀)进行确认性研究。

方法

20 名 MDD 患者和 20 名匹配的对照者接受度洛西汀 60mg/天治疗 12 周,在基线和第 12 周(研究结束时)通过标准 ERG 记录和汉密尔顿抑郁和焦虑量表以及 Young 躁狂评定量表进行监测。

结果

在达到最终反应的抑郁患者中,ERG 平均杆状 b 波振幅从基线到第 12 周显著降低(p=.024),从最高秩值降低到无反应者和对照组的基本未改变的值。

局限性

样本量小且缺乏多次评估。

结论

至少一些对度洛西汀有反应的 MDD 患者可能表现出特定的 ERG 模式,这可能表明存在特定的生物学背景。如果通过更大样本量的研究得到证实,这些结果可能会进一步阐明不同类型抑郁症的生物学决定因素,并在不同治疗干预措施下显示出不同的反应模式。

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