Gedge Laura, Beaudoin Ashley, Lazowski Lauren, du Toit Regina, Jokic Ruzica, Milev Roumen
Centre for Neuroscience Studies, Queen's University Kingston, ON, Canada.
Front Psychiatry. 2012 Feb 24;3:12. doi: 10.3389/fpsyt.2012.00012. eCollection 2012.
Brain-derived neurotrophic factor (BDNF) levels are decreased in individuals with depression and increase following antidepressant treatment. The objective of this study is to compare pre- and post-treatment serum BDNF levels in patients with drug-resistant major depressive disorder (MDD) who received either electroconvulsive therapy (ECT) or repetitive transcranial magnetic stimulation (rTMS). It is hypothesized that non-pharmacological treatments also increase serum BDNF levels.
This was a prospective, single-blind study comparing pre- and post-treatment serum BDNF levels of 29 patients with drug-resistant MDD who received ECT or rTMS treatment. Serum BDNF levels were measured 1 week prior to and 1 week after treatment using the sandwich ELISA technique. Depression severity was measured 1 week before and 1 week after treatment using the Hamilton Depression Rating Scale. Two-sided normal distribution paired t-test analysis was used to compare pre- and post-treatment BDNF concentration and illness severity. Bivariate correlations using Pearson's coefficient assessed the relationship between post-treatment BDNF levels and post-treatment depression severity.
There was no significant difference in serum BDNF levels before and after ECT, although concentrations tended to increase from a baseline mean of 9.95-12.29 ng/ml after treatment (p = 0.137). Treatment with rTMS did not significantly alter BDNF concentrations (p = 0.282). Depression severity significantly decreased following both ECT (p = 0.003) and rTMS (p < 0.001). Post-treatment BDNF concentration was not significantly correlated with post-treatment depression severity in patients who received either ECT (r = -0.133, p = 0.697) or rTMS (r = 0.374, p = 0.126). It is important to note that these results are based on the small number of patients included in this study.
This study suggests that ECT and rTMS may not exert their clinical effects by altering serum BDNF levels in patients with drug-resistant MDD. Serum BDNF concentration may not be a biomarker of ECT or rTMS treatment response.
抑郁症患者脑源性神经营养因子（BDNF）水平降低，抗抑郁治疗后升高。本研究的目的是比较接受电休克治疗（ECT）或重复经颅磁刺激（rTMS）的难治性重度抑郁症（MDD）患者治疗前后的血清BDNF水平。据推测，非药物治疗也会提高血清BDNF水平。
这是一项前瞻性单盲研究，比较了29例接受ECT或rTMS治疗的难治性MDD患者治疗前后的血清BDNF水平。在治疗前1周和治疗后1周使用夹心ELISA技术测量血清BDNF水平。在治疗前1周和治疗后1周使用汉密尔顿抑郁量表测量抑郁严重程度。采用双侧正态分布配对t检验分析比较治疗前后的BDNF浓度和疾病严重程度。使用Pearson系数进行双变量相关性分析，评估治疗后BDNF水平与治疗后抑郁严重程度之间的关系。
ECT治疗前后血清BDNF水平无显著差异，尽管治疗后浓度从基线平均值9.95 ng/ml升至12.29 ng/ml（p = 0.137）。rTMS治疗未显著改变BDNF浓度（p = 0.282）。ECT（p = 0.003）和rTMS（p < 0.001）治疗后抑郁严重程度均显著降低。接受ECT（r = -0.133，p = 0.697）或rTMS（r = 0.374，p = 0.126）治疗的患者，治疗后BDNF浓度与治疗后抑郁严重程度无显著相关性。需要注意的是，这些结果基于本研究纳入的少量患者。
本研究表明，ECT和rTMS可能并非通过改变难治性MDD患者的血清BDNF水平发挥其临床作用。血清BDNF浓度可能不是ECT或rTMS治疗反应的生物标志物。
