School of Psychology, University of Tasmania, Hobart, TAS 7005, Australia.
Biol Psychiatry. 2013 Jun 1;73(11):1059-63. doi: 10.1016/j.biopsych.2012.10.033. Epub 2013 Jan 8.
The most effective treatment for posttraumatic stress disorder (PTSD) is exposure therapy, which aims to facilitate extinction of conditioned fear. Recent evidence suggests that brain-derived neurotrophic factor (BDNF) facilitates extinction learning. This study assessed whether the Met-66 allele of BDNF, which results in lower activity-dependent secretion, predicts poor response to exposure therapy in PTSD.
Fifty-five patients with PTSD underwent an 8-week exposure-based cognitive behavior therapy program and provided mouth swabs or saliva to extract genomic DNA to determine their BDNF Val66Met genotype (30 patients with the Val/Val BDNF allele, 25 patients with the Met-66 allele). We examined whether BDNF genotype predicted reduction in PTSD severity following exposure therapy.
Analyses revealed poorer response to exposure therapy in the PTSD patients with the Met-66 allele of BDNF compared with patients with the Val/Val allele. Pretreatment Clinician Administered PTSD Scale severity and BDNF Val66Met polymorphism predicted response to exposure therapy using hierarchical regression.
This study provides the first evidence that the BDNF Val66Met genotype predicts response to cognitive behavior therapy in PTSD and is in accord with evidence that BDNF facilitates extinction learning.
创伤后应激障碍（PTSD）最有效的治疗方法是暴露疗法，旨在促进条件性恐惧的消除。最近的证据表明，脑源性神经营养因子（BDNF）促进了消退学习。本研究评估了 BDNF 的 Met-66 等位基因是否会预测 PTSD 患者对暴露疗法的反应不佳，该等位基因导致活性依赖性分泌减少。
55 名 PTSD 患者接受了为期 8 周的基于暴露的认知行为治疗计划，并提供了口腔拭子或唾液以提取基因组 DNA 来确定他们的 BDNF Val66Met 基因型（30 名 Val/Val BDNF 等位基因患者，25 名 Met-66 等位基因患者）。我们研究了 BDNF 基因型是否可以预测暴露疗法后 PTSD 严重程度的降低。
分析表明，与 Val/Val 等位基因的 PTSD 患者相比，BDNF 基因的 Met-66 等位基因患者对暴露疗法的反应较差。使用分层回归分析，治疗前的临床医生管理的 PTSD 量表严重程度和 BDNF Val66Met 多态性预测了对暴露疗法的反应。
本研究首次提供了证据表明 BDNF Val66Met 基因型可以预测 PTSD 对认知行为疗法的反应，并且与 BDNF 促进消退学习的证据一致。
