Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Escola d'Infermeria building 5th floor, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Catalonia, Spain.
Psychopharmacology (Berl). 2014 Apr;231(7):1389-95. doi: 10.1007/s00213-013-3343-y. Epub 2013 Nov 8.
Atomoxetine (ATX) is a non-stimulant drug approved for the treatment of attention deficit hyperactivity disorder (ADHD). Although animal models have provided evidence that brain-derived neurotrophic factor (BDNF) is involved in the effects of ATX in the brain, there are no studies of BDNF in ADHD patients undergoing treatment with ATX.
The aim of this study was to evaluate the possible changes in serum levels of BDNF in adults treated with ATX and its relationship with clinical improvement.
A total of 54 adults with ADHD (age 33.43 ± 8.99 years) without any medical or psychiatric comorbidities were treated with ATX for 3 months; 35 of them completed the protocol. The clinical data for ADHD diagnosis, including Conners' ADHD Rating Scale and blood samples, were collected at baseline (V1) and at the end of the treatment (V2).
Adults with ADHD who completed ATX treatment for 3 months showed a significant improvement in their clinical symptoms. No significant differences were found in BDNF levels before and after treatment with ATX in the whole group of patients (p = 0.15). The inattentive subgroup of ATX responders showed a decrease of serum BDNF after 3 months of ATX treatment (p = 0.05) not present in the combined subtype (p = 0.82).
These results suggest that BDNF is not directly involved in the neurobiological mechanisms of ATX-induced improvement of clinical symptoms of ADHD. The differences between the combined and inattentive subtypes in serum BDNF changes suggest selective ATX-induced effects in the function of brain circuitry.
阿托莫西汀（ATX）是一种非兴奋剂药物，批准用于治疗注意缺陷多动障碍（ADHD）。尽管动物模型已经提供了证据，表明脑源性神经营养因子（BDNF）参与了 ATX 在大脑中的作用，但在接受 ATX 治疗的 ADHD 患者中，尚无关于 BDNF 的研究。
本研究旨在评估 ATX 治疗的成年人血清 BDNF 水平的可能变化及其与临床改善的关系。
共有 54 名无任何医学或精神共病的 ADHD 成年患者（年龄 33.43±8.99 岁）接受 ATX 治疗 3 个月；其中 35 名完成了方案。在基线（V1）和治疗结束时（V2）收集了 ADHD 诊断的临床数据，包括 Conners' ADHD 评定量表和血液样本。
接受 ATX 治疗 3 个月的 ADHD 成年患者的临床症状明显改善。在整个患者组中，治疗前后 BDNF 水平无显著差异（p=0.15）。ATX 反应者的注意力不集中亚组在接受 ATX 治疗 3 个月后血清 BDNF 水平下降（p=0.05），而联合亚型则无此情况（p=0.82）。
这些结果表明，BDNF 不直接参与 ATX 诱导 ADHD 临床症状改善的神经生物学机制。在血清 BDNF 变化的联合和注意力不集中亚型之间存在差异，提示 ATX 对大脑回路功能具有选择性诱导作用。
