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在急性情绪发作期间使用延长释放喹硫平治疗时,外周脑源性神经营养因子的变化:双相情感障碍患者无药物治疗的开放标签试验。

Peripheral brain-derived neurotrophic factor changes along treatment with extended release quetiapine during acute mood episodes: an open-label trial in drug-free patients with bipolar disorder.

机构信息

Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.

出版信息

J Psychiatr Res. 2012 Nov;46(11):1511-4. doi: 10.1016/j.jpsychires.2012.08.017. Epub 2012 Aug 30.

Abstract

Molecules that are involved in neuronal intercommunication and adaptability of neural networks, such as brain-derived neurotrophic factor (BDNF), are targets of pathophysiological investigation in bipolar disorder (BD). Quetiapine is an attested treatment in this disorder, used in acute mood episodes. The aim of this study was to report prospective changes in serum BDNF levels in drug-free patients in acute mood episodes of BD who received treatment with extended-release quetiapine along a 16 week follow-up. Assessments were performed at baseline and weeks 2, 4, 8 and 16 with the Young Mania Rating Scale, the Hamilton Depression Rating Scale and the Clinical Global Impression severity scale. In these visits, serum BDNF levels were measured. Mixed effect models were used to investigate longitudinal changes. Twenty-five patients were included for this analysis, seventeen in a current depressive episode and eight in a manic/mixed episode. A significant improvement from baseline to endpoint was displayed. In the mixed model, significant main effects for episode and time appeared, and a time versus episode interaction showing increasing BDNF levels with time in those with a depressive episode, but a decrease in BDNF levels with time in those with a manic/mixed episode. BDNF may be a biomarker with differential response according to the polarity of mood episodes.

摘要

参与神经元间通讯和神经网络适应性的分子,如脑源性神经营养因子(BDNF),是双相情感障碍(BD)病理生理学研究的靶点。喹硫平是该疾病的一种已证实的治疗方法,用于急性情绪发作。本研究的目的是报告在接受长效喹硫平治疗的无药物治疗的急性情绪发作的 BD 患者中,血清 BDNF 水平的前瞻性变化,随访 16 周。在基线和第 2、4、8 和 16 周进行评估,使用 Young Mania Rating Scale、Hamilton Depression Rating Scale 和 Clinical Global Impression 严重程度量表。在这些就诊中,测量了血清 BDNF 水平。使用混合效应模型来研究纵向变化。对 25 名患者进行了此分析,17 名处于当前抑郁发作,8 名处于躁狂/混合发作。显示出从基线到终点的显著改善。在混合模型中,出现了发作和时间的显著主要效应,以及时间与发作的相互作用,表明在抑郁发作患者中,BDNF 水平随时间增加,但在躁狂/混合发作患者中,BDNF 水平随时间下降。BDNF 可能是一种生物标志物,根据情绪发作的极性有不同的反应。

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