Rabie Menan A, Mohsen Manal, Ibrahim Mona, El-Sawy Mahmoud Rania
Institute of Psychiatry, Ain Shams University, PO Box 11657, Cairo, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
J Affect Disord. 2014 Jun;162:67-72. doi: 10.1016/j.jad.2014.02.038. Epub 2014 Mar 24.
There is a growing body of evidence that serum brain derived neurotrophic factor (BDNF) is altered during the episodes of bipolar disorder. The aim of this study was to investigate serum BDNF levels in bipolar disorder patients during manic and depressive episodes and its clinical utility in bipolar disorder compared to other psychiatric disorders.
The study was conducted on 80 Egyptian patients, who were classified into 4 groups: group Ia (25 patients with depressive episodes), group Ib (25 patients with manic episodes), group II (15 patients having Schizophrenia) as pathological controls and group III (15 healthy subjects) as controls. All subjects were diagnosed according to DSM-IV, assessed using the Hamilton Rating Scale for depression (HAM-D), and the Young Mania Rating Scale (YMRS). sBDNF concentrations were measured using the quantitative sandwich enzyme immunoassay technique.
sBDNF showed significantly lower levels in patients with depressive episodes or manic episodes. The best cut-off for sBDNF in discriminating depressed patient from healthy control was ≤33,000pg/ml (AUC=0.891, sensitivity of 84%, and specificity of 80%). Moreover, the best cut-off for sBDNF in discriminating mania patients׳ group from healthy control was ≤29,500pg/ml, (AUC=0.984, asensitivity of 96%, and specificity of 86.7%).
Only a small sample size was considered which included only drug free patients. BDNF was measured in serum not in CSF or brain tissue.
Low sBDNF levels are strongly associated with active phases of bipolar disorder, in depressive and manic episodes.
越来越多的证据表明，双相情感障碍发作期间血清脑源性神经营养因子（BDNF）会发生变化。本研究的目的是调查双相情感障碍患者在躁狂和抑郁发作期间的血清BDNF水平，以及与其他精神障碍相比，其在双相情感障碍中的临床效用。
对80名埃及患者进行了研究，这些患者被分为4组：Ia组（25名抑郁发作患者）、Ib组（25名躁狂发作患者）、II组（15名精神分裂症患者）作为病理对照组，III组（15名健康受试者）作为对照组。所有受试者均根据《精神疾病诊断与统计手册》第四版（DSM-IV）进行诊断，使用汉密尔顿抑郁量表（HAM-D）和杨氏躁狂量表（YMRS）进行评估。采用定量夹心酶免疫测定技术测量血清BDNF浓度。
抑郁发作或躁狂发作患者的血清BDNF水平显著降低。区分抑郁症患者与健康对照的血清BDNF最佳临界值为≤33,000pg/ml（曲线下面积[AUC]=0.891，敏感性为84%，特异性为80%）。此外，区分躁狂症患者组与健康对照的血清BDNF最佳临界值为≤29,500pg/ml（AUC=0.984，敏感性为96%，特异性为86.7%）。
仅考虑了小样本量，且仅包括未用药的患者。BDNF是在血清中测量的，而非脑脊液或脑组织中。
低血清BDNF水平与双相情感障碍的抑郁和躁狂发作的活跃期密切相关。
